the SHU box

another journey begins

2012-01-31T06:24:00.010-05:00

made it
it was a harrowing trip, but we're back in durham! yesterday's trip involved:

◼ handling of luggage/passengers in tow, including 2 checked bags, 2 bulky carry-ons, 1 pair of crutches, 1 uncomfortable husband, and 1 31-week gestation
◼ 2 hour drive from vail to denver. luckily there was almost no snow/ice on the roads!
◼ first-ever foray through airport security as a wheelchair passenger and his +1
◼ unanticipated 2 hour delay before actually leaving denver [maintenance issue = instills lots of confidence . . .]
◼ 3.5 hours in the sky from denver --> charlotte
◼ q3-4 hour pain meds and lovenox for the patient
◼ 1 missed connection [due to the delay below]
◼ several helpful airport employees and several NOT so helpful ones . . .
◼ a 27-minute flight from charlotte --> durham
◼ 1 harrowing journey with luggage from the baggage claim to the car
◼ 15 minute ride home

we began packing at 5:30 am [well, to be fair, it was mountain time] and arrived home at 10 pm EST. currently, the patient is resting comfortably, and i am under just a little bit of stress.

anxious
or to be honest, really it's more than a little. my to-do list has reached epic proportions, and i feel like i am falling short on rest and self-care. i realize that pregnancy is not a medical condition, but at this size it's just not quite as effortless. i was at the point where i was going to really enjoy getting some more help [around the house, etc], and now the tables have turned completely.

from last week - i feel like i've grown significantly since this pic already
however, it is what it is. and i do have perspective -- while i have bouts of feeling sorry for myself [yes, in addition to my husband], i realize that things could have been MUCH worse. we are lucky this happened now rather than later. we are lucky this was a LEG injury and not involving the neck/back/head. we are lucky to have the financial abilities to recover from the incident without going into debt.

therefore, i am going to try as hard as i can to to:

a) suck it up and be strong

and

b) take care of myself AND josh right now.

after all, it can't be any harder than being pregnant with other kids at home, right? especially if the kids got sick? with contagious [and messy] gastroenteritis?

several items blurred to protect the innocent
it's intimidating, but i refused to get psyched out by my own list!

i will take things one day at a time - what i can get done, i'll get done.

i will take time for me -- which includes working out, sleeping enough, and the preparation of healthy meals.

i will prioritize and let some tasks go until later.

i will ask for help!

off to start the day
with as much calm and normalcy as i can muster. here goes nothing . . .

visuals from vail

2012-01-29T13:36:00.006-05:00

just an update

before

yes, this is the actual x-ray
also, it's his left leg, not his right like i initially thought! [so now he's broken BOTH fibulas. impressive!]

after

4 screws. 1 long rod. a ~2 hour surgery. lots of pain meds.
and the hospital bill ONLY came to $34,000! [THANK GOODNESS FOR INSURANCE!!]

one recovering ex-skier!

don't worry, the oxygen came off as soon as we got there
we were actually allowed to be discharged yesterday because josh passed his physical therapy "test" of starting to maneuver around on crutches. however, he is definitely not ready for major trekking around just yet.

we have our hotel room set up like a mini-recovery ward, and we'll be headed back to NC tomorrow morning. the journey to the airport --> onto the plane --> onto another plane --> to the parking garage --> to our apartment is going to be a bit challenging as you might imagine, but i am sure we will have plenty of help.

it's very pretty here, but the 8,000-foot altitude has been a bit of a challenge. with mild pregnancy-induced anemia and reduced lung capacity, i'm finding myself breathless at times, and sleeping was very hard [i seem to be much more comfortable when upright -- getting that uterus weight AWAY from the lungs]. however, it's definitely doable and i'm confident that the magic of fetal hemoglobin physiology will keep baby girl nice and oxygenated.

this graph is such a med school favorite!
on the docket for today
✔ movies! we have moneyball and 50/50 for today

✔ pain med management

✔ getting arrangements set for tomorrow

✔ take-out

✔ admiring the view:

i hope everyone is having a good weekend . . . or at least making the best of it, even if it wasn't quite as expected.

i guess we can call it a babymoon

2012-01-28T05:00:00.000-05:00

premonition
i hadn't mentioned it, but josh headed out to a conference in colorado this week -- i guess because i don't like to advertise when i will be home alone.

he was going to a vascular surgery conference to give a talk -- very impressive, and he worked really hard on it. he was also going to do a little skiing, as the conference was in vail.

the truth is: i had a very uneasy feeling about it. i made him promise several times that he would NOT try anything daredevilesque on the west coast slopes. after all, the last time he had skiied was with me and i think it was around 2003 in pennsylvania. he certainly outperformed me [that's not hard], but neither of us were experts. as i kissed him goodbye the nagging impulse that something bad was going to happen didn't really fade. i just . . .somehow . . . knew.

when he called me at 4:45 pm [i was in clinic], i picked it up and jokingly greeted him with, "so, did you break your leg?"

there was a pause and suddenly i was horrified to realize that i already knew the answer.

not his tibia. but you get the idea
it was a right tibial fracture and he was going to the OR in a couple of hours, 2 time zones away. he would have nails of some sort placed in there. and he would be spending at least 2 days in the local hospital there. the only consolation to me was the realization that they probably have excellent orthopedics in the ski haven.

plans, schmans
suddenly my fantasies of a relaxing weekend flew out the window. it's times like these that i realize that 'plans' are just that -- one potential idea of what the next block of time might hold. things can change in an instant. even though i know it's "only" a broken leg, i knew i needed to be with him in the hospital, just like he stayed with me through my recent mishap. i called my OB [fine, i called our close friend dr. s -- but he happens to legitimately be one of the OBs in the group i see!] to get his opinion on whether it was safe to fly, and he reassured me that it was fine.

so, by the time you read this, i will be on an unexpected little adventure [my first-ever flight booked less than 12 hours in advance!] at altitude to be with josh. hopefully the surgery will be LONG over with and he will be feeling okay! he will be in a cast and on crutches for at least the next 2 weeks, so that will be interesting [it's his right leg, too, so no driving].

getting him around is going to be interesting -- but i can only imagine that people are likely to be helpful towards the clearly pregnant woman accompanying her injured husband in a wheelchair. the only question is: which of us will be at greater risk for DVT? heh, i kid, but i also worry, because i'm very good at that. but there are so many what ifs in this case that it's probably better i just move on and try to enjoy the ride. after all, things could have been MUUUUUUUUCH much worse. and i did say i wanted a babymoon . . .

what a week

2012-01-27T06:47:00.006-05:00

by the numbers

workouts for the week: 1, so far.

nights with page-free sleep: 1, i think. and it was glorious.

to-do items in my planner for the week: 8

percentage completed: 0%

proper meals cooked: 0

plans are not necessarily reality
pages answered: many

estrogen level: high and still climbing

[source]
moodiness quotient: also extremely high. and likely related.

minutes spent online ogling baby-related items: too many

i really tried not to play the waiting game this week, but i will be completely honest: i STRUGGLED to get through it. thankfully i get to sign off of the pager in 54 minutes [i have clinic today, which is much more fun!] and will have a very peaceful weekend to relax and recover. and check off a few of those neglected boxes . . .

happy #(*$&@# friday!

hanging on . . .

2012-01-26T07:28:00.003-05:00

one more night on call!
and just two work days before i get a real BREAK. . .

today
✔ gym
✔ notes / catch up on labs
✔ walk around and see patients
✔ attempt to check off myriad checkboxes!
✔ answer pages [until friday morning]
✔ answer 928237 [it seems] emails
✔ hit the grocery store because we have NOTHING
✔ crash
✔ sleep [i hope!]

really, there's nothing that terrible about today. but i'm just ready for a day off!

time to get my single-tasking on. if only i could turn off the pager . . .

week 30!

2012-01-25T07:00:00.004-05:00

hitting the 30s
i wrote before about the myriad waiting games in pregnancy -- starting with the whole TTC process. personally, i find this to be one of the more significant ones for a couple of reasons.

most importantly, i can say from my residency NICU experiences that most babies born after 30 weeks are not the truly sick ones. in fact, unless there are other issues involved [genetic defects, infections, etc], most babies at this level of prematurity do incredibly well.

second, 30 was the number i always associated with being really, really pregnant -- ie, when i would hear someone was 30 weeks i'd think of them having their baby in the [relatively] near future. it's the last 6.2 miles of the pregnancy marathon! and as someone who hasn't really bonked one yet, i am hoping the same will be true for this journey.

30 weeks! if you want to hide it, pose face-forward and wear black . . .

but the side view is always dramatic
the lighting in our apartment is so hard! i want to get some decent pictures taken before it's too late [aka before the whole swelling part inevitably begins]. hopefully i'll be able to get outside with josh at some point!

the rundown
feeling: huge. weight gain has continued to be reasonable [i think i'm at +17 lbs at 30 weeks] but the growth still seems astronomical, and my abdomen feels tighter and more packed by the day! it doesn't help that i am still measuring 2 weeks ahead -- perhaps i'm getting to experience a normal 32-week belly a bit early. i know in 7 weeks or so i'll look back at these pictures and laugh at my naivete, but right now it just feels like a LOT on my frame. sleeping is not fun. lying on the couch is even frustrating -- i want to relax, but can't seem to get my muscles [and considerable bulk] into a favorable position. the oddest part is the times i am most comfortable are when i'm moving -- walking or even running! this brings us to . . .

workouts: ever since my little mishap on the sidewalk, i've taken my workouts indoors. i'm clumsy by nature, have a totally messed-up center of gravity right now, and can't even see my feet -- a recipe for disaster i think if i continue to run outside. however, i have continued to get my [necessary] endorphin buzz via the treadmill and elliptical. currently, my favorite is a run/walk combo: 4 minutes at 5.5 mph alternating with 2 minutes 3.5 mph with some incline for 30-40 minutes. i've never minded the treadmill -- and i've also never fallen off of one, so i feel like this is safe. i've been supplementing with weights and prenatal yoga although i'd love to be doing more of it!

prep: we still have no semblance of a nursery, but we have a lot of baby stuff that just needs to be organized -- once josh moves his desk out of the baby's room, that is! our dresser/changing table was delivered yesterday, our futon is here, and our crib will be on its way mid-february. we aren't going crazy with decorating [we're going to live here only ~16 months after our baby girl is born] but i do want things neat and organized before her arrival.

thanks to generous relatives and friends, we now are set with strollers [including the bob!], baby carrier [i ended up going with an ergo], a TON of 0-3 and 3-6 month clothes [mainly beautiful hand-me-downs from my sister-in-law!], bouncer, car seat, breast pump, and so much more.

oh, and we do have a name picked out -- subject to change, of course, but i think we're pretty set. it's very feminine and pretty and classic and i can't wait to use it out in the open!

fatigue: definitely coming back. although i'm on call this week, so i know the 2 am phone calls aren't helping. because i'll be headed back into the lab, this will be my last 7-day stretch on the pager until post-baby . . . not that i'm looking forward to being woken up alternately by the pager AND a hungry little one! [but i'll survive.]

things i am really glad i did [so far, anyway!]
since i am not even finished with my very first pregnancy, i may not be the best person to turn to for advice. still, i can look back on a few earlier decisions and say what has worked up until this point!

bought good spots bras
i've been using the same 2 since earlier in my pregnancy and they still work. i don't think i could have continued running without the juno! even if i don't fit into these once my milk comes in, i will still consider them worthy investments [especially since i hope to get pregnant again!].

started wearing maternity clothes early!
i feel like so many people resist buying maternity clothes until late in the game -- and i don't get it! i've been wearing the same clothes since week ~13 or so, and most things have continued to work just fine. i am very happy to have bought 3 pairs of gap maternity pants and some dresses which have become very comfortable staples. the only items that are starting to become problematic are a few of the shirts, which are getting to be short because of the new expanse of belly. while i may end up having issues with swelling and have trouble fitting into things by the end, at that point i will be in the lab and i really don't care if i have to work in the same pair of yoga pants for a few weeks -- i'd rather save up for clothes to wear after pregnancy :)

on that note, i'm also really happy to have borrowed a lot of clothes. after building a reasonably functional wardrobe, it has been very easy to resist shopping. because come on: i want anthro, not pea in the pod!! and i know it's only a matter of time . . .

continued working out through the whole deal
next time i might transition to the treadmill earlier, but i am really happy to have kept up with physical activity throughout. for one, if i had failed my diabetes test this week, it would have been the one consolation for me to think that at least i tried my best to get in the recommended daily exercise! second, the times that i feel my absolute best [and the most 'normal'] are during and after a workout.

__ weeks to go . . .
now that i can actually envision getting there, i've started to think of my due date as a less exact point -- after all, less than 5% of women actually deliver on that magical 40 week mark. will i end up delivering at 37 weeks or 41?! i'm kind of guessing the latter, given my family history and generally slow-to-respond reproductive tract up to this point, but does that mean i'll measure 43!?

i have a feeling that whenever i go, i'll be more than ready.

sweet relief

2012-01-24T06:22:00.009-05:00

i passed!

i was so relieved to see these numbers last night -- they aren't even borderline! please note, the reference ranges above are not for gestational diabetes -- but i beat those by a wide margin. i find it hard to explain why my blood glucose was lower by 35 points 1 hour after consuming twice as much sugar, but i'm too happy to care very much.

bring on the gelato!

[source]
kidding. sort of.

the test was pretty annoying. i felt moderately ill all day after chugging the 100g glucose drink -- the equivalent of approximately THREE cans of coke, but without the caffeine or carbonation. however, i did get to sit around reading for a few hours without the pager -- almost worth the 4 blood draws and all the worry. thank you all for your good wishes and tips yesterday!

tired
my 60+ year old attending proclaimed this past weekend the busiest she has ever had -- which is saying something. the combination of the 24/7 pager, longer days, and perhaps hitting the 30-week milestone has left me exhausted.

as usual, i find myself already pining for the weekend [yes, i know it's only tuesday -- but all i can think about is "three more nights on call!"]. as i've written many times before, i really can't stand living in 'waiting' mode.

ways i will approach the rest of this busy week

✔ keep the house in relative order. when i start feeling like we're living in the middle of a disorganized mess, my energy is sapped even further and cleaning up feels insurmountable. as soon as i finish this post i am going to spend 15 minutes straightening up, and i know it will be well worth it!

✔ keep the bar reasonable. work has been demanding. i'm on call. this is not a good week for elaborate dinners. i do need to go grocery shopping after work, and josh and i will be living off of simple healthy fare for the next couple of days. nothing lost there.

✔ avoid watching the clock at work. honestly, sometimes i think i'm more stressed about over the IDEA of being at work late than the actual practice of staying a little longer. i'll be done when i'm done, and it will be better if i work on finishing up loose ends before heading out. plus, i might as well savor this flexibility now because once i have to head to day care by closing time, the race really will be on.

✔ continue to avoid excessive time online. i 100% agree with the idea in leo's latest post that excessive internet time is just another ineffective [and therefore bad] habit for dealing with stress/boredom. i enjoy catching up with my favorite sites over breakfast but honestly, i think that's plenty of internet/social media/online time for any given day.

and with that, i'm off to clean up and get a quick workout in before the work day begins. what are your survival tactics for tough weeks? i can always use additional ideas . . .

food for thought
i really liked michelle au's piece on her experiences as a full-time physician and mom of 2 [soon to be 3]. even though i have aspirations to eventually work part-time, i don't think anyone should be criticized for their childcare choices, wherever they lie on the spectrum.

well, hello!

2012-01-23T06:43:00.012-05:00

less than a week
it really hasn't been that long since i sat down and performed my usual morning writing ritual -- but it feels like forever. in fact, i'm feeling a little rusty . . . but i'm back! and all is [pretty much] well. i have much to report after a 6 day stint away, but i'm definitely glad to have taken a little break. while i did not go internet-free or anything drastic like that, i did spend less time online overall last week [as per my january resolution] -- and it felt very natural. and good.

i read more [yep, still 1Q84 -- still not quite halfway through!], slept more, watched more TV [not necessarily a proclamation to be proud of, but it's true], and worked more -- a lot more. the past week in the world of pediatric endocrinology has been an insanely busy one!

4 episodes in, and josh and i are now completely addicted.
business as usual
life went on, of course! i got in my typical workouts in:

we ate dinners from february's real simple. unfortunately, the recipes are not yet online -- but they were honestly all very good!

maple-mustard salmon with brussels sprouts and red onion
potato, spinach, and ham frittata
and my favorite -- prepared by josh while i worked late [total role reversal for us!]:

southwestern stuffed peppers
and i grew some more, as per usual:

blurry gym pic depicting me in my 30-week glory!
a not-so-sweet surprise
on thursday, i had the traditional glucola face-off -- this is a 1 hour screening test for gestational diabetes. essentially, you drink this bottle of excruciatingly sweet liquid:

[source]
. . . and then you get your blood sugar checked one hour later -- anything under 140 is considered normal. to be completely honest, i fully expected to pass. after all, none of the previously pregnant bloggers i have followed [jen, emily, sabrina, and many more!] had an issue, and like them i have been consistently active throughout my pregnancy. sure, my eating habits weren't perfect, but i think overall i have done pretty well. and despite measuring 2-3 weeks ahead, my weight gain has been right on track -- really even on the lower end of the normal range.

since we are allowed to access our own records, i checked into mine at the end of the [long] workday and saw what i had not expected to see:

fail. in fact, pretty major fail. so this morning, i am sipping water instead of eating my usual breakfast and i will be heading into the clinic soon to go through a 3-hour version of the initial test -- with double the glucola [ughgh] and 4 blood draws.

of course, endocrinology nerd that i am, i have done some research into my statistical chances of passing. here are the cutoffs for the test:

2 out of 4 values above the cutoffs are consistent with a diagnosis of gestational diabetes
most people [something like 80-90%] of people who fail the initial glucola do pass the 3 hour. however, as the number on the glucola goes up, so does the positive predictive value of the screening test. looking at a few different studies, i think i have about a 50/50 chance today. no pressure!

baby will be okay . . .
while annoying and truly surprising to me, i realize that even if i fail it's not the end of the world. it would mean changing my diet [sad news for this carb queen, but it would be temporary!], and in the absolute worst case scenario, going on insulin temporarily [i honestly cannot even imagine this!]. i do have concerns about how late in my pregnancy i ended up getting screened, but there's nothing i can do to fix that now. chances are still very good that our baby will be healthy as long as i follow all of the guidelines from this point on. and i'd much rather be dealing with this than many other pregnancy issues!

off to the clinic!
so, wish me luck! on the positive side, at least i get a 3-hour break from the pager . . . back with more updates and perhaps some deeper thoughts tomorrow.

breather

2012-01-18T06:51:00.003-05:00

back in NC
but taking a little time off to recenter myself. everything is great [fantastic, really!] but i think i just need a little blogging palate cleanser.

i'll be back in a few days! ♥

bending the days

2012-01-16T12:51:00.007-05:00

being here now
lounging by the pool with a book and savoring every peaceful moment.
[i LOVE this book so far, by the way. i am 1/3 through its 925 pages.]

time warp
right now, normal routines seem much farther away than they truly are. i love this passage i read today:

Tengo knew that time could become deformed as it moved forward. Time itself was uniform in composition, but once consumed, it took on a deformed shape. One period of time might be terribly heavy and long, while another could be light and short. Occasionally the order of things could be reversed, and in the worst cases order itself could vanish completely. Sometimes things that should not be there at all might be added onto time. By adjusting time this way to suit their own purposes, people probably adjusted the meaning of their existences. In other words, by adding such operations to time, they were able -- but just barely -- to preserve their own sanity. Surely, if a person had to accept the time through which he had just passed uniformly in the given order, his nerves could not bear the strain. Such a life, Tengo felt, would be sheer torture.

--Haruki Murakami, 1Q84

Food for thought on a luscious day off.

showered

2012-01-15T16:58:00.007-05:00

i feel so lucky, so loved, and so thankful.
i wish the struggling me from just under one year ago could have seen this future with a crystal ball. i am so HAPPY these days! and even though i know there is nothing i can really do to understand the magnitude of the changes that are coming, i think we are starting to feel . . .

a little more prepared. if that's possible :)

this lovely shower was thrown by our miami beach family [josh's side], and it was amazing -- pink buttons everywhere [the theme was "as cute as . . ."].

button bouquets:

button treats:

MORE button treats:

and yes -- even MORE button treats.

another fabulous treat was getting to spend time with JT -- who i actually met at HLS two years ago. JT brought her beautiful baby girl and had so much wisdom to impart.

josh got a diaper dude [that way he won't feel ridiculous carrying around my orla . . . ]

please ignore my slightly crazed expression
and let me just say our baby is going to be one well-dressed chica.

[why are baby jeans just the cutest thing ever!?!?]

it was a fantastic day!

and getting ready just makes me think over and over again about how we are getting close to meeting her. i can't wait.

success!

2012-01-14T20:46:00.003-05:00

laundry done.
apartment cleaned.
boxes cleared out.

and we made it!

from out the window!!
buenos noches de miami! more tomorrow . . .

tidbits

2012-01-13T06:46:00.006-05:00

✰ yesterday was fine, despite my trepidations. and now -- due to a 3-day weekend, a clinic, and a quasi-job-interview [pre-interview?], i get 5 whole days off of the pager! YESSS.

at the end of the day, i rewarded myself with some of this:

i really hope i pass my gestational diabetes test next week . . .
✰ portlandia is coming to durham!!! i bought tickets the second i saw this.

put a bird on it
✰ ideally, i would like to do yoga, organize our apartment, and do [necessary] laundry today -- in addition to diabetes clinic and a work dinner tonight. we'll see how things go.

✰ we're off to miami tomorrow -- yes again. this time, it's for a fun reason -- a baby shower!

the only way i like winter

+ some friday link love
✔ i am newly motivated by caroline's beautiful meal-planning post! this week was an example of what happens when there are no plans, food-wise. and it reminded me of why it's so much better to do it!

✔ if i had different resolutions this year, i would be all over the declutter & organize calendar i read about on chelsea's blog. check it out if you are looking to whip your surroundings into shape!

✔ zenhabits advice on dealing with clutter. our apartment is currently getting slowly filled up with baby-related . . . stuff and i'm already looking to streamline. of course, i want to have the essentials but i want to avoid excess and also have it all organized in some fashion. hmmm.

✔ congratulations to heather @ SoS on her new bundle!

okay, 30 minutes of pre-work yoga starts . . .
NOW.

moment to moment

2012-01-12T06:28:00.002-05:00

wishing the day away
from the moment i woke up today, i found myself wishing i could do anything other than get on the pager and go to work for what is likely to be a 12-hour+ day [we have an evening conference].

i fantasized wildly about:

✔ cleaning / organizing [i feel so haphazard in the new year thus far!]

✔ catching up on laundry

✔ answering emails! [if you've emailed me this week, i apologize for not responding yet and promise i will get back to you!]

✔ spending some quality time on the couch with 1Q84

✔ grocery shopping so that we actually have something in the house other than bread, peanut butter, and cereal

✔ sitting down to really regroup on my goals and perhaps get started on some of my 10/100 [we're down to 83 days before my due date, after all . . .]

but that is not today
today will be:

✰ an early run/walk workout as soon as i finish this post

✰ a busy morning in the hospital

✰ an afternoon in lab [i have to stop by to go over some data because of an abstract i'm planning to submit early next month]

✰ dinner / meeting with regional pediatric endocrinologists [triangle trifecta of duke, unc, and wake med]

and everything will still be okay. i will not run out of clothes to wear. no one will care if the bathroom isn't sparkling clean [except maybe me]. we will eat out/takeout a few times. nothing catastrophic will happen and i can still have a great day -- no less perfect than the one above.

confessions + embarrassments [and some links]

2012-01-11T06:14:00.010-05:00

confessions
◼ my one and only january resolution hasn't been going that well. things started off nicely, but i got derailed by last friday's little mishap.

◼ the last time i did my spanish was a week ago. i KNOW! work has been busier and i'm starting to get more tired. not great excuses, but it is what it is.

◼ i have complete and utter baby brain. i feel absent-minded and foggy. i have a hard time focusing on presentations -- particularly anything science-related. i'm getting the idea that february and march in the lab will be interesting . . .

◼ part of that is just being distracted because i think about the 28-weeker inside of me approximately 1 million times per day. every time she moves [which is A LOT], every time i get up from a seated position, and every time i look down to see what seems like a foreign object on my lap. yesterday the first thing i did upon arriving to work was not to check labs, but to investigate crib mattresses [it seemed absolutely essential at the time!].

◼ pottery barn kids now owns me. even though i KNOW it doesn't matter, we [okay, i] decided to splurge on the set i had been drooling over for a month.

we have been incredibly lucky to have received extremely generous gifts from family/friends already, and i am coming into some fantastic hand-me-downs [ie: gently used breast pump!], so this is likely the only major purchase we will really be shelling out for [other than the uber-practical IKEA futon. and uhh, day care. but we've been saving for that for a long time now]. so, i felt okay about it. and i can't wait to actually put our nursery together!!

◼ last night's dinner: cheese-filled tortilla, some yogurt with granola, and strangely addictive ikea KEX cookies. i tried to rationalize salsa as my 'vegetable', but i realize that is totally lame. this had nothing to do with nausea/aversions [haven't had those for months] -- just pure laziness, as josh was out at a work function. i do feel guilty about it because i don't want to shortchange our now rapidly-growing baby in any way. i am determined to do better!

◼ i kind of like my new treadmill workouts probably because i have finally added walking intervals to my runs. i'm definitely at the point where even running at 5.5 mph (1% incline) for 30 minutes is a really HARD workouts for me, and i don't want to be pushing so much!

embarrassments
i never thought i'd ever want to post anything like this online, but this blog is the best record i will have of my first pregnancy, and i want to capture even the little things.

taken while in bed last night. i was reading and she was just going crazy in there! i think she must like murakami . . .

don't worry, it's under 30 seconds!
links
♥ the beautiful spring 2012 moleskine catalog! i sort of want everything in there. but i'm actually thinking about getting this:

♥ angeliki's thoughts on murakami -- i agree with many of her points!

♥ gretchen rubin's take on being overwhelmed by big projects. personally, i wish she'd stick to writing [i don't love her on video!] but i like many of her points.

♥ i am dying to clear out my life for the new year, but haven't gotten to do it yet! i think the weekend of january 28-29 is going to be dedicated to this.

useful note

2012-01-10T06:25:00.003-05:00

amount of time spent on hold with credit card company at 6:30 pm on monday:
32 minutes

[gave up]

amount of time spent on hold with credit card company at 6:25 am on tuesday:
0 minutes

the early bird gets the worm [or the customer service!]

taking care of some things around here + i'll see you tomorrow :)

successful enough!

2012-01-09T06:03:00.005-05:00

it was close
so the answer to yesterday's cliffhanger [will an IKEA futon fit in a prius?] was . . .

ALMOST.

with the front seats ALL the way up, we did get both the futon and mattress in there. but this left no room for the reasonable seating of two people -- one of us 6' and the other with an inconveniently bulky uterus. plus, there was zero visibility out of the back -- not the safest for a ~2 hour drive.

so, we had it shipped [$129 for any locals curious] and it's coming tuesday. it all worked out! we also took home a few random goodies [2 lamps, some cheapo cutting boards, and a box of KEX, off the top of my head].

i know josh had a fantastic time [he looooooooves the IKEA cafeteria. a lot.]

this was his midmorning snack
and this was mine. yum
fueled up, we spent about an hour and a half browsing and confirmed our futon choice:

beddinge resmo
it's actually quite comfortable and has a real mattress with springs, which i think will be great for guests. we went with brown instead of blue for a bit more versatility.

i may end up doing a fair amount of breastfeeding while lounging on this couch, so i am also happy to say that all of the upholstery is machine washable!

after our loading fail, we made it to molly + ben's to catch up and meet the whole family. so lovely to hang out! med school gossip was traded with parenting tips.

after a delicious lunch [#2 for josh i guess] we headed back on the road to durham. the drive took us about 2 hours and 15 minutes -- really not so bad.

dinner was a little rushed [a hurried stop at whole foods on the way home . . .]

but we made it happen!
josh really wanted steak rather than salmon and i didn't really care, so i gave in. josh made steak au poivre and i worked on some roasted potatoes and brussels sprouts.

easy. fairly classy. DONE.
i got kind of sick of the steak while eating it and had to donate some to josh, but somehow found extra room for this:

luscious bread pudding made wih love [and pound cake] by k

not the healthiest day [but fun!].

not the least stressful week [but it worked out okay!].

headed into a new work week today -- things look a little bit insane on the inpatient side but i am determined to go in with grace. monday, you can BRING IT.

today:

2012-01-08T07:37:00.010-05:00

pilgrimage!
we are on a mission.

the goal:

1) drive to charlotte to arrive at IKEA when it opens [11 am]

2) get futon so that guests can stay at our apartment [needed urgently because my parents are coming in february!]

3) potentially fit said futon [in boxes] into prius. i'm not sure about this one . . .

4) not get too distracted by all of the other random stuff at the scandinavian superstore [this might be even more impossible than #3]

5) lunch with molly, an old friend from medical school! <-- i feel old that i can even say that. over the past ~7 years, molly and her husband ben have had FOUR children [including a recent addition] and she is one of the happiest mothers i know. i will trust anything and everything she has to say about anything baby-related! so excited for this visit.

6) drive 2.5 hours home [potentially with futon]

7) go to whole foods so that i can get ingredients for this, plus a few little appetizer treats:

image + recipe from the simply recipes blog -- elise never lets me down
8) dinner with k + dr. s at our apartment

whew. wish me luck . . .

just to show you all that i'm all in one piece
almost-28-week pix. in real clothes this time!

still fairly subtle from the front [though the dark shirt helps!]
getting serious from the side
anyone else going on any crazy missions this weekend? any tips for successfully fitting a futon into a prius? hmm.

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1.6.11

workout: i decided to just sit this weekend out after friday's drama! no real medical reason; it just seemed like it was time for a little break. but i will be back to my usual routine [sans outdoor runs] monday AM.

dinner in
sometimes i feel pressured to get out [to movies, restaurants, etc] NOW because it will be so much harder later. but honestly, i'm not that hard to please. sometimes a quiet dinner in and a movie in bed is absolutely perfect.

superfast saffron rice with shrimp
i used brown rice [the easy pre-made frozen kind!] and it turned out nicely. it wasn't the MOST exciting of all dishes, but i love anything shrimp-related and this would be a great one to make early in the week for lots of lunch leftovers.

our movie was winter's bone. so far it was good but we both fell asleep.

not the friday i expected

2012-01-07T07:58:00.009-05:00

we'll just call it practice
before i detail the events of the last 24 hours, i want to reassure you all that everything is okay! [come to think of it, i'm pretty sure i wouldn't be here writing about it otherwise].

but let me tell you, when i jauntily wrote about heading out for a run yesterday morning, i never suspected that i would end up stuck in bed with monitors on for the next ~ 20 hours.

comfy . . .
and yet that's exactly what happened.

i am not graceful.
this in itself is certainly nothing new! in fact, i'd say that once a year or so, i bite it on the pavement on a run. see, look: in 2008 i did it, sans bump. i remember that fall well because it left a hole in my favorite winter running pants! [i still wear them, despite said hole. they are too nice to throw away].

just like that day in 2008, i tripped over essentially nothing yesterday. an uneven sidewalk. a tiny rock. i don't even know. all i know is that one moment i was 2 blocks from home and super-happy about my workout, and the next i was splayed out on the concrete feeling like a jerk, an idiot, and an unfit mother. and i was terrified.

i landed on my knee [just a scrape - less dramatic than 2008 for sure!] and kind of my side. it definitely was not a direct blow to the uterus, but the impact felt pretty jarring. i walked the rest of the way home in tears and then debated what to do.

the right thing?
i drank some juice [wanted to feel her move!! and she did] and pondered my options for about 5 seconds [because i figured what could the doctor DO about it if i did something horrible!?] but then picked up the phone to the nurse triage line. i knew that if i didn't let them check me out, i would be racked with worry about what i might have done. besides, i felt like you are 'supposed' to call the nurse if something like that happens. so i did, expecting them to perhaps bring me in to clinic so they could wave an ultrasound wand over everything and proclaim that all was okay.

BUT. apparently that's not how things roll when you are 27 1/2 weeks. the nurse said i had to go to the triage area -- ie, labor and delivery-land to be checked out. she suggested they would probably monitor me for 'about an hour' and then let me go home. i felt a little silly going in for something so seemingly minor, but at that point i knew i had to follow her instructions.

a very long hour . . .
i let my [very nice and understanding] attending know what was going on, and she signed onto the pager, and i headed to the triage zone. i was put in a gown, which felt entirely unnecessary, and strapped to a bed with two monitors: one for the baby's heart rate and another to detect any uterine contractions. i picked up my phone and started surfing around to pass the time, but figured it wouldn't be too long.

but then, a nurse midwife came in looking somewhat serious. apparently i was having contractions -- something like over 4 in an hour, which was officially too many for me to leave. she suggested that perhaps some of this was due to relative dehydration, and recommended an IV. i wasn't sure why a 30 minute run in cold weather would have left me dehydrated, but i complied. my first ever IV fluids -- i wondered what it would feel like, although i was dreading the every-15-minute bathroom trips that were likely to ensue.

except i guess was a little dehydrated -- and cold -- and anxious -- and with small veins. they stuck me 3 times before finally giving up and bringing me a liter of water to drink. i set to work, hoping it would help get my uterus over whatever was making it irritable. i went to the bathroom every 30 minutes, which was really fun because i had to unhook and reposition the monitors each time.

unfortunately, it didn't work. i continued to contract a few times an hour over the next couple of hours. and before i knew it, i was admitted to the L&D ward for overnight observation. for falling on the sidewalk!

being a patient
this part was so weird. i have been at duke hospital in some facility since 2002 -- all the way through med school, residency, and now fellowship. but i have never seen the inpatient experience from the other side. the meals that i looked at wistfully during residency sometimes [it's true! you can get hungry on a 30 hours shift] . . .

not so tempting when they are on your tray. although i was happy to eat -- initially i was on a clear liquid diet [in case something were to go horribly wrong and i required anesthesia . . .] and that is not fun for anyone, let alone a pregnant chick who had just gone for a run. by 6 pm, i was able to negotiate with the resident on call, and josh brought me a burrito <-- best husband ever.

what the doctor ordered?
maybe all i needed was a burrito all along, because after that, my uterus apparently calmed down [i say "apparently" because i could not feel most of these contractions -- they were just picked up on the monitor]. josh and i settled in for a night with the monitors. we slept with the sound of our baby girl's heartbeat in the background -- which was actually quite nice. i had very nice nurses and residents and even got to meet anesthesia, although i informed them i would not be needing their services for another 12 weeks or so.

and in the morning, the resident came in and proclaimed that all was well. NO contractions overnight, and a textbook-perfect heartrate tracing. i was ready for discharge! josh and i were out of there in 10 minutes. and now i'm home.

lessons learned?
well, as much as it pains me to say it, i think i'm done with outdoor runs for the duration of the pregnancy.

from ~ 6 weeks
to 27 weeks
the OB assured me that running is still fine, but i just don't want to fall again, and i don't think it's totally outside the realm of possibility given my shifted center of gravity and -- well, my record speaks for itself. i still plan on hitting the treadmill at a slow jog [i've never fallen off of one and can't really imagine it!] and keeping up with the elliptical. josh has promised to go for walks with me, and of course yoga is still a great option.

SO -- that was how i spent my friday. and um, happy weekend!

44 minutes

2012-01-06T05:46:00.004-05:00

friday morning ritual
for the third week in a row, i sat down to my usual daily discipline -- and then decided that the mess in our apartment was TOO MUCH to ignore.

and then i cleaned it up. and magically, i feel like a whole new person starting a much better day.

the weekly slide: our typical pattern
✔ monday: woohoo, new week! things start out on the up-and-up. things are kept straight. to-dos get done. dinner is usually something easy, because we have our grand rounds that evening, but it's always a proper meal and the kitchen is clean afterwards. i do often take a rest day because my weekends tend to be more active, and something about the earlier wakeup call does make me a little tired.

✔ tuesday: still going strong. i usually run in the morning. i am efficient at work, catching up on lots of loose ends [monday tends to be a bit too frantic for this]. dinner is something good -- like this week's farro risotto [yum]. things stay organized, for the most part

✔ wednesday: doing all right. work is fairly smooth sailing. i still typically go about my usual morning routine, with a workout, spanish practice, etc. dinner tends to be something easier [or leftovers]. but i'm starting to get tired. the dishes may be washed, but not necessarily put away. mail starts to pile up on my desk. sometimes [if i'm smart], i go to bed early.

✔ thursday: admittedly, i'm starting to get tired of the daily grind by most thursdays. it's not that i don't like my job; it's just that the early wakeup call, being "on" and pleasant for the work day, and the prospect of coming home and cooking dinner starts to seem like an insurmountable task [after all THE DISHWASHER ISN'T EVEN UNLOADED!]. i'm testier on the pager and the end doesn't seem like it's in sight [especially if i'm slated for call over the weekend or on overnight!]. if there is a day of the week when all my systems start to fail, it is thursday.

sometimes watching the previous night's episode of our favorite show provides a much-needed escape
✔ friday: by the end of the week, i'm sort of over it all and ready to start again. luckily, friday is often my clinic day and i really love the change of pace provided by the outpatient schedule. plus, i'm at the point where i actually know a fair number of my patients pretty well, and it makes for a really fun experience. but the morning is usually terrible because the apartment has usually fallen into an impressively sad state of disarray, and i hate going into the weekend living in -- and therefore feeling like -- a cluttered mess.

so: my newest addition to the weekly cycle has been a friday morning cleaning session. today in exactly 44 minutes i was able to clean the kitchen, including the disgusting floor [okay, i didn't do a good job, but it's BETTER], make our bed, clean up any random clothes/items lying around, and get my desk surface back to the relative state of serenity that i crave:

ahhhhhhhhhh
and now it's off to run, with a clear mind and a much better attitude. definitely 44 minutes well-spent!

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1.5.11

workout: none. josh and i headed to work together [i had taken my car in for routine service] which meant getting to work at 6:45 am. it was actually quite productive but left me sapped, and there was NO WAY i was working out upon returning home.

dinner: cereal is starting to become a thursday night classic. not sure how i feel about that.

everything else: nah. although i am still doing well with my january resolution!

what matters

2012-01-05T05:41:00.005-05:00

sweating the small stuff
yesterday i spent over an hour looking at baby bedding and then went to sleep completely anxious over . . . well, i'm not even sure.

i'm stressed about fitting everything we need into our apartment. [guest futon. rocker. our desks. crib. giant stroller. other baby essentials.] i absolutely love our living space but i'm not sure it's going to be all that functional with a baby or toddler.

i'm nervous about a safe sleeping setup for those newborn days [bumpers & blankets = SIDS risk according to the AAP. it's too bad because they are pretty!].

i'm worried about our future finances & budget.

i'm definitely concerned about my ability to handle a baby on my own [because josh's work schedule is going to be crazy, especially the first few months] and also about balancing childcare with work after those 12 weeks are up.

but i need to remember
that it doesn't really matter. i will take life one day at a time. i will have plans [come on, i WILL have plans] but avoid expectations. our baby won't ever remember whether she was changed on a fancy pottery barn dresser or an IKEA knockoff.

she will release all kinds of bodily fluids onto her sheets regardless of thread-count or pattern.

she will thrive living in this apartment -- cluttered or not -- as long as i can supply her with plenty of food, shelter, and love.

and someday i believe i will look back at those beginning baby years and just wish they hadn't gone so fast. we will live each day the best we can.

i think that's what matters.

27 week update

2012-01-04T06:25:00.004-05:00

no news is good news
i think my last update was at 24 weeks, although there is obviously no shortage of baby-related banter around this blog these days.

so anyway, i'm getting pretty pregnant.

again with the workout gear -- i swear i wear real [maternity] clothes, too! i'm not sure this picture even gives justice to the bump's current massive state, but i promise: it's sizeable.

there's some debate as to when the 3rd trimester actually begins, but according to this calculator, i'm now there based on 2 of the 3 definitions. i say it counts!

the rundown
symptoms: i definitely wouldn't say i'm miserable, but i no longer feel like the energizer bunny i did in the early second tri. i am starting to have back pain pretty regularly [sometimes shooting - ouch] and i sleep horribly [and YEARN to sleep on my back! arghgh!]. i have had a few annoying nosebleeds, too.

physical changes: my uterus is TAKING OVER. it has become quite firm and is disturbingly veiny [NOT publishing any picutres!]. i have so much fun playing with baby's various body parts when i'm lying quietly - she'll stick a hand or foot out and i can gently push it back in. i never realized how much you could see/feel from the outside!

name: chosen, i think! but still subject to change, potentially, so i won't be sharing it here until she's born :)

weight gained: ~15 lbs. this puts me on track to gain likely somewhere between 25 and 30 total [the recommended range is 25 - 35], and i would be really happy with that.

workouts: yep, still running! i have slowed down considerably, though. interestingly, i haven't really had issues with the belly feeling like it's bouncing around too much -- the limiting factor now is just my stamina [breathing-wise] and sometimes my back. i am currently running for 3 miles outside at somewhere between 10 and 11 minute miles. on the treadmill, i cover slightly less ground in 30 minutes [with 1% incline on the whole time].

i don't run on back-to-back days -- instead, i hit the elliptical 1-2x/week and aim for 1-2 days of either weights of yoga [usually it's more like 1]. things like lunges have definitely become far more challenging with the added weight.

cravings: nah. i feel like i just eat a lot, but that's probably to be expected! i don't even miss the forbidden foods that much, although i would like to eat a bagel with smoked salmon post-delivery. just putting that out there.

thankful: i feel like i'm complaining so much above, but i'm just trying to paint an accurate picture! overall, i think i have been incredibly lucky so far through this pregnancy. just a few things i am thankful for . . .

♥ #1 - that the baby is still inside me. and alive & kicking [literally].

♥ no abnormalities or complications so far. the next hurdle is my glucose test which i will be getting at over 29 weeks -- on the late side, but hopefully okay!

♥ no swelling so far. my rings + shoes are still fine. and yes i still wear heels!

♥ my energy level is still pretty decent so far -- sometimes i walk around and forget that i'm carrying another person inside of me

♥ my maternity clothes all still fit fine -- for now.

♥ both sides of the family have been so supportive and incredibly generous with love, excitement, and amazing gifts already! i have official showers coming up this month [in miami] and in february [here]. so much fun.

♥ your advice so far! absolutely LOVE getting first-hand info from the mom-trenches about baby equipment, time-saving strategies, magical baby-whispering techniques, etc. THANK YOU!

coming soon to the US
murakami movie!

norwegian wood was my murakami "gateway book", and i've read almost all of his novels since. this came out in japan in 2010, but i'm looking forward to the US release.

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1.3.11

workout: it was FRIGID cold [and still is], so i decided to hit the gym. 30 minutes on the treadmill at 5.5 mi/hr, 1% incline; 2 minutes walking to cool down. it still wasn't full for january!!

mark bittman's farroto
i was originally supposed to make this rather labor-intensive recipe on monday night, but things got switched around for the sake of freshness [ie: using up raw chicken].

turns out i have more time to cook elaborate dinners when i am avoiding the internet! and the outcome was worth it -- smooth and creamy, with a nutty bite from the farro used in place of traditional arborio rice. i used kabocha squash instead of butternut which seemed to work well.

served with a side of roasted brussels sprouts
recommended for an evening when you have time to leisurely stir the risotto pot!

spanish: check -- and i don't think i forgot everything [just a little]. we had a spanish speaking patient today and i almost was brave enough to say a few rudimentary phrases while waiting for the interpreter. almost.

back to it! / baby gear fun

2012-01-03T05:49:00.008-05:00

deep breathing in the baby store
josh and i made the pilgrimage to our local buy buy baby yesterday just to look at things [not to buy!]. it was actually REALLY helpful and ended up solidifying a lot of our decisions! the hardest part seems to be striking a balance between opting for purchases that will make things easier vs. going crazy for too much stuff that just fills up the apartment with clutter [my nemesis]. i absolutely love our living space, but we do not have a huge amount of room. i fully expect that a good percentage of our space to get filled with baby paraphernalia, but every piece better be something that serves a purpose.

and if possible, not completely garish and offensive-looking . . .

this chair would be fine in a big house but does not need to be the focal point of our entire kitchen/dining area/living room
luckily, there are plenty of alternatives these days:

inoffensive and hopefully functional keekeroo chair
our biggest dilemma right now remains: how to set up the baby's room so that it can also be a comfortable guest room for visitors. right now we are thinking about a futon [which will also become my nursing/lounging couch]. as usual, we'll probably go the way of good ol' IKEA:

beddinge havet. just can't beat the prices + respectable design
in fact, we're even planning on hacking an IKEA dresser into a changing table <-- their idea

a step down from this pottery barn beauty but approximately $400 cheaper
the extra weekend day

in addition to baby browsing, we ended up going to see a movie

would definitely recommend -- simple but very nicely done
and then spending a leisurely evening on the couch and then in bed reading.

if only every weekend had an extra day . . .

--------------------------------------------------------------------------

1.2.12

workout: ended up skipping it -- my body wanted a break!

super-easy chicken quesadilla

i actually don't think you really need a recipe to make chicken quesadillas -- just throw in chicken, beans, some veg of our choice, and top with cheese -- how can you go wrong? but sometimes it's just nice to have the inspiration from the pages of a magazine. served with some leftover soup from last night for extra veg action.

spanish: about to get to it after about a 10 day hiatus -- ahh! hoping i haven't forgotten everything already . . .

a good year so far

2012-01-02T07:40:00.006-05:00

expectations may go . . . but lists will stay
because personally, i find it far easier to truly let go when the laundry is done, fridge is full, and i know i'm on top of all of the little loose ends life has to offer.

i think the key to lists like these is flexibility. knowing that it's okay if not every item gets checked off. realizing that if something fun comes up [yesterday: an impromptu elmo's brunch with friends] that it's a bonus, not a hindrance to so-called 'productivity'. but putting things down truly gets them out of my head so that the rest of life can be enjoyed to the fullest. and in spite of [or perhaps because of?] the few loads of laundry that got done yesterday, i would call this a fantastic weekend thus far.

plus, today's list is looking pretty sweet.

sunday highlights
other than laundry . . .

✰ the gym all to myself on 1/1! who would have thought!? [behind me is the cardio area, unpictured . . . and also completely empty.]

✰ making a list of baby stuff we want to get [i refuse to say 'need' because really, no one needs a pottery barn crib or a baby bjorn]:

✰ prenatal yoga + a failed attempt at fro-yo with my lovely friend sue [loYo was closed!]

✰ entering the 3rd trimester! [well, according to one method of calculation, anyway]

✰ delving into this book rather than wandering the internet:

liking it so far! reading this extremely heavy volume [physically heavy], i can now imagine the utility of a kindle. but i still love turning real pages . . .

all right, off to get ready for today's MASSAGE! and this time, josh is getting one, too. happy new year observed!

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1.1.12

they were out of black-eyed peas
everyone seems to have jumped on the black-eyed pea bandwagon this year, so i had to sub butter beans in this stew. it wasn't the most exciting burst of flavors, but it was extremely healthy and a nice change from the typical side salad.

we served it with the last of our leftover pizza!

grilled chicken, tomatoes, olives, and pesto from the pizzeria - right in our apartment complex

workouts at the end of the 2nd tri:

one last list for this post!

running is still going surprisingly well -- i'll write more about this in a later post.

2012: we made it!

2012-01-01T08:22:00.008-05:00

1.1.12

just looking at that date makes me feel fresh, clean + ready for anything
2012 is here! and i'm ready. not to disparage 2011, but it was sort of a mixed bag. of course, wonderful things ended up happening around here, but it was not the smoothest of rides.
i'm not expecting a bumpless journey this year either, but it will be an exciting adventure, no doubt!

i'm geared up for this month's resolution, which is simply to spend less time wandering around on the internet. specifically, i'm aiming for less than an hour on weekends and under 30 minutes on weekdays. as usual, i've devised a [paper] tracking system which i'll share at the end of the week when it's filled in. i am looking forward to reclaiming this time in my life to use for . . . well, not exactly sure what yet, but OTHER THINGS.

ringing it in
last night was certainly not the first new year's eve where i was fast asleep before midnight -- but it was probably the first in a LONG time where champagne consumption had nothing to do with it. josh and i had plans to attend a party some friends were holding, but we wanted to cook a fancy dinner first.

our fancy beverages . . . can you guess which is mine?
one of these shots illustrates how i feel about that:

but even i'm not sure which one.
i MIGHT have had an ounce or two [less than 1/2 a glass] of the real stuff as well [hey, recent evidence backs me up here]. pretty sure baby girl did not mind.

josh wanted steak diane, so i put him in charge of making it! i think this may have been his first and last cooking experience in 2011 . . .

but despite the lack of recent practice, i think he did an excellent job.

perfectly-cooked beef tenderloin steak drenched in luscious sauce + served with asparagus
this intimate feast was the perfect ending to the year -- although we sadly never made it out to our party!

maybe next year. <-- probably not though

today
we have an exciting agenda of theusualweekendstuff, plus i want to make a list of baby items we want [not necessarily specifics yet, but just to know what we're looking for].

ooh pretty + organized!
i think my nesting instinct is kicking in early . . . i blame pottery barn.

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12.31.11

workout: last run of the year -- 3 miles in 30:36 [~10:12/mi]. this felt slower so i was pretty pleased with my pace! i have no idea how many miles i ran in 2011, but i'm pretty sure it's a record low since 2004 or so. and obviously, it was worth it.

spanish 'n' reading 'n' stuff: will be back to the routine on tuesday!

resolutions 2012 [part 4]: the list

2011-12-31T09:09:00.003-05:00

without further ado . . .
12 months. 12 goals -- or whatever, we can call them "habits" if it makes leo happier.

shown above are the general categories -- the specifics will be . . . well, more specific! and many of these are subject to change, particularly anything post-march. i am going in with hopeful plans and delightful anticipation, but no expectations.

tomorrow, i'll go a little deeper into january's resolution. reducing my time spent online is definitely NOT a new ~~goal~~ habit for me, but it is something i find quite difficult! i am hoping that with this as my primary focus, it will be easier. plus, i see it as a gateway resolution: with less time spent online, i will have more time to do other more rewarding things. a perfect setup for the later months, right?

guess we'll see!

ritual cleansing
i cleaned up this place just over 1 week ago -- and entropy has struck yet again. however, i am looking forward to spending a leisurely morning scrubbing and rearranging and putting away -- nothing like starting a new year with clean clothes, dishes, and countertops.

and with that, i'm off to enjoy this last day of 2011! what a year . . .

ps
if you're NOT trying to detox from the internet this year, i really liked this post about balancing planning and spontaneity [in her case, while traveling]. full disclosure: i know the author from college and found her post on facebook! she's an internal medicine doctor and i love her writing style.

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12.30.11

workout: rest. but i plan on a run outside today -- the high is 62!

old havana sandwich shop
josh was actually off yesterday while i headed to work: insanity! he picked me up from the hospital at 1:30 pm and whisked me away for a lovely lunch break at old havana sandwich shop -- his choice, as you might imagine.

however, i was quickly won over by this cute eatery's menu of cuban-style sandwiches. because of the whole 'no deli meat' thing, i couldn't get a traditional cuban, but i opted for the "el caney", a combo of slow-roasted pork, avocado, mustard, and super-melty cheese. it was served on the classic flattened cuban bread [although it was actually baked at the decidedly un-latin guglhupf!] and was hearty and delicious, served with a few maduros for good measure.

cuban-style sandwich with maduros and a fairly well-behaved pager
i have had traditional cuban sandwiches [and medianoches] in miami and this was on par, although i did miss the currently forbidden ham.

the only problem with this lunch is that i finished all of it and then had a VERY hard time working afterwards -- i wanted a nap! but at least the pager stayed [mostly] quiet throughout the little outing. and as of now, i'm pager-free until tuesday! YEAHAHHH!

one more dayyy [and winner!]

2011-12-30T07:13:00.004-05:00

late
i slept until 7 this morning -- unthinkable for a work day! and the wonderful part is that i slept right through night 7 on the pager. [don't worry, i didn't sleep through pages -- i just didn't get any!]. and that's it for overnight call in 2011.

didn't quite come to fruition, but almost
given that i'm late, i'm going to keep this short and sweet. let me just say i am so excited for 5 pm to roll around so that i can begin a 3-day weekend! it's not that i really worked all that hard this week; it's just that it got really old being on while it seemed like everyone around me was either off, or gearing up for a nice long break.

finally, i have to say that doing the bare minimum over the past 7 days [while being on the pager] was just . . . unsatisfying. it wasn't as restful as i imagined, and yet i managed to get bored! i realized that i'd actually rather be busy at work -- time moves so slowly when i don't get to spend any of it in that lovely flow state. i think this is why i typically prefer clinic situations. since appointments are scheduled, you're not at the mercy of the peds endo gods to determine whether any given day will be feast [overwhelming] or famine [blah].

anyway, it's off to work for one last 9 - 5 and then a little break, made even sweeter because josh is off too.

plans so far
✰ see a movie [young adult probably?]
✰ pick out baby stuff + register
✰ massages [both of us] monday!
✰ a lot of relaxing and just hanging out

excited already!

winner!!
i was totally impressed at how many of you wanted that planner [i figured most people who love planners would be set by now :) ].

here's our random # . . .

and the winner is rachel, and i promise i didn't pick her because of her flattering comment!

rachel, i've emailed you and will get you in touch with amy who will send out the planner! and i am pretty sure some of us [ahem, myself] would love an update on how it works out!

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12.29.11

workout: 3.1 [ish?] in 33 minutes. still running the whole way, but i'm definitely slowing down, and my footpod just ran out of batteries which is maybe a good thing!

eatingwell
i don't subscribe to the magazine, but eating well has a lot of recipes online, and the few i've tried have been decent, as well as very healthy.

this stuffed creation was no exception:

acorn squash stuffed with white beans and chard
the recipe is here. it's definitely on the lighter side, so if you're pregnant and hungry like i am you may want to accompany it with something additional -- in my case, lots of brie and crackers while waiting for josh to get home. mmm.

planner procrastinator? [giveaway!]

2011-12-29T06:52:00.007-05:00

it's not too late!
yesterday reader amy emailed me with an insanely generous offer. she decided to go with the lovely journal J for this year, and somehow wound up with an extra planner on her hands.

and i'm not just talking about some throwaway deal. this laurel denise 2012 planner looks beautiful and quite practical as well.

as seen on the well-appointed desk
the pages are arranged cleverly so that an entire month can be viewed along with a to-do list for each day [and week]. it looks perfect for any listmaking aficionado who likes things to be all in one place.

anyway, amy couldn't tear any of her friends away from their digital scheduling systems, but figured she would find some paperphiles hanging around here, and offered it up as a giveaway.

i will squelch the urge to keep it for myself [because two planners are NOT better than one as far as i'm concerned . . .] and offer it up as suggested!

to win this laurel denise planner, just leave a comment on this post telling me why you want it! the winner will be chosen by random number generator tomorrow [so that the winner can begin 2012 as on time as possible :) ] and amy will ship it out.

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upcoming posts
◼ working at half-speed [why i did not really enjoy my faux-cation]
◼ baby gear decisions [help requested!]
◼ the final 2012 resolutions post + introducing january's goal
◼ pregnancy update coming up on the third tri
◼ clean[ish] eating not my resolution, but some improvements that are necessary
◼ thoughts on running during pregnancy: at the 2/3 mark

stay tuned!

resolutions 2012 [part 3]

2011-12-28T06:58:00.006-05:00

so much to look forward to
2012 is going to be big.

[so is 2013 for that matter -- finishing fellowship and moving and getting what i HOPE will be my first big girl grown up doctor job - ahh!].

i am looking forward to so many exciting things in the new year -- from kick-off massages [yes, josh wanted one too!] . . .

. . . to certain circumstances that will probably ensure that we will never get massages together again:

my apologies for the recycled post-run pic -- i need to showcase my giant fundus in some non-running gear soon
and even though i'm NOT starting a new planner [sad!], i am dorkily* looking forward to the fresh start that invariably comes with a new year. all of the magazine covers are clean and white and for once i'm not the only one making obsessive-looking lists and schemes to improve life.

the funny thing is that for once i'm not planning on starting off with 18 or even 6 new year's resolutions [i had 6 last year]. instead, i'm taking a cue from unclutterer and going monthly this year!

this serves two purposes:

✔ i believe i will be able to focus much better on just one new goal at a time

✔ there is going to be so much change in my life this year that i'm not sure which resolutions are going to apply down the road!

i have tentative ideas for each month [coming up in a later post], but i am also keeping things open to change.

what are your resolutions this year? and if you've blogged about them, post the link! some people get sick of all of the 'new year!' posts, but i find reading other people's lists of goals completely fascinating.

* if dorkily is not a word, it should be.

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12.27.11

workout: 30 minute jog on the treadmill at 5.5 miles/hr and 1% incline. interestingly i tend to be [marginally] faster outside these days, probably because the downhills provide a much-needed break.

i'm sorry, baby because i did NOT eat the way a pregnant woman is supposed to yesterday [ie, vegetables / vitamins / nutrients]. but it just felt right.

plus yogurt pretzels, an apple, and string cheese
dinner of champions.

10/100: round 2

2011-12-27T06:44:00.009-05:00

entering double digit territory
back in april, i decided to try out an interesting tactic i had seen on some other blogs; the "100 in 1001" list, which has grown so popular that it now even has its own website [interesting]. except i scaled mine back -- 1001 days seemed like WAY too far in advance to be planning! who knows if what i want to do now will still be relevant in 2014?!

and so, 10 in 100 was born. <-- you can see the whole list there if interested. overall, it was mostly a success -- though i admit firefly pose was still way beyond my reach [both literally and figuratively . . .] by the end.

someday! [source]
99 days
so why bring this up again? well, i'm at a logical starting point, or close to it -- 99 days before my official due date*! here are 10 things i'd love to do before our baby makes her grand debut.

i tried to keep this list more fun/optional -- the things i might not do if i didn't remember or think about them! therefore, it does not include obvious to-do items like finalize her name [although i think we're pretty firm!], stock up on diapers and get necessary furniture and set up nursery.

i will try to report back with interim progress!

* i kind of anticipate going over, so it will probably be >100 anyway!

happy new year?!
i had way too much fun designing new year's cards on shutterfly yesterday! here's the one we're not using [didn't want to pay the double postage for a square card!]

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12.26.11

workout: nada. i felt SOOOOO lazy yesterday and it felt great to just do nothing!

en papilotte
sounds way fancier than 'a bunch of stuff thrown into parchment paper and baked', right?

either way, this thai curry fish packet from january's CE was tasty and super-easy. the recipe is not online but i can post/send to anyone if there is interest.

winter break

2011-12-26T07:29:00.008-05:00

faux-cation
so i'm NOT on vacation this week by any stretch of the imagination -- i'm actually still on call until friday at 5 pm [then i do get 3 days off! yay!]. but i've decided to make things easier on myself and sort of just take some extra time to rest this week.

my alarm will be set a little later, and i am going to take a break from spanish and non-essential work responsibilities [reading, various projects]. i am going to delve into 1Q84 and look for more movies to watch. i am still going to work out, but i'd do that on a normal vacation anyway!

and yes, i'm still going to post -- i have RESOLUTIONS to write about, after all!

catching up from your christmas festivities?

✰ effortless living
✰ xmas traditions

switching gears: 2011 playlist
my 2011 in music form:

i realize these songs are not even all from 2011 [most are, though]. these songs were just my personal soundtrack for the year. i can't tell you how many times i teared up in the car while listening to arcade fire:

So can you understand?
Why I want a daughter while I'm still young
I wanna hold her hand
And show her some beauty
Before this damage is done

But if it's too much to ask, it's too much to ask
Then send me a son

-- "the suburbs", the suburbs

do you have a 2011 playlist?
i now regret not making playlists annually! i'd love to hear what 2003 sounded like right now. or 1987 . . . probably would lead off with this:

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workouts: pregnancy week 25

still running. still definitely getting slower. still totally happy just to be out there!

xmas traditions

2011-12-25T08:53:00.004-05:00

christmas without expectations . . .

In a quiet way, unwind
Doing Christmas right this time.

-- "christmas wrappings" by the waitresses, 1981

i had a lovely day yesterday. i did my stint in the hospital but was finished by lunchtime! the rest of the day was spent wrapping gifts [yes, i will be sending out a few late ones!], running around the neighborhood, listening to pandora's christmas stations, and watching movies on demand.

charlie brown xmas was a family tradition growing up despite the fact that we don't celebrate in the religious sense [if there is such a thing as lapsed judaism, i would say that describes my family fairly well!].

so nostalgic! [source]
our other family christmas traditions
✔ christmas music for pretty much the entire month of december
✔ annual blasting of "christmas wrappings" with traditional dance [what? it's so catchy!]
✔ often a trip to the movies

we watched this one at home instead -- i really liked it!
✔ takeout. indian or chinese!

last night's official xmas eve dinner, thanks to china king
my sister even brought me an unexpected holiday gift:

supercute desk caddy from bigso box of sweden
and i celebrated the high-50s temps with a run:

pushing 26 weeks and showing it!
merry christmas to all -- whatever your traditions may be!

effortless living?

2011-12-24T07:06:00.010-05:00

an interesting concept
i arrived home yesterday in a contemplative mood and decided to spend the evening reading leo babauta's latest book, the effortless life. it is available in pdf [or iPad/tablet/reader form] and the price is up to the buyer -- one can contribute anything from $0 to the suggested retail of $15.99.

i've been a little negative about some of the current ideas and teachings on zen habits [and it still makes me sad that he one day he proudly proclaimed that he had no health insurance . . . ], but i did really love this book and found myself strongly impacted by some of his ideas.

i know many of you are out celebrating today and few are hanging around reading blogs! but if you find yourself with some free time as the year winds down, i recommend checking out this quick read. you may find that some of his points resonate with you, too.

ideas i loved from the book
◼ identify true vs. false needs
true need = food, shelter, clothing [basic clothing -- not anthro].
false need = having the latest gadget; cable; fancy trips and experiences

now, i am absolutely NOT one to be preaching minimalism. i love life's little luxuries, from fancy paper to lululemon to fantastic shoes to [now] baby outfits that cost more than -- well, more than they should. but i think it's important to take time and acknowledge what is truly a need and what is just extra bonus.

i may want slightly absurd-looking gaga-esque anthro wedges this spring.
but i don't need them.
it helps to provide perspective and to get out of the mindset of: "if only i had that . . . [fill in the blank]." it also means that i can still be happy even during times that the little extras aren't quite so accessible.

this extends to less tangible false needs, as well: the need to feel "successful" [ie, the true conventional 'american dream' version of success]; the need for outside approval [gretchen rubin's "gold star" phenomenon].

◼ let go of all expectations
in no way do i believe this is easy. but i am convinced that it is one of the keys to a calm and happy life. this includes the expectations of how other will/should behave -- any idea of control in this arena is utter illusion, anyway. it includes expectations of exactly what life will be like in 10 years [though i still maintain it's FUN to think about the various possibilities], 1 month, or even 5 minutes from now.

it includes expectations for what this call weekend will be like and how many times my pager will go off.

yeah right . . .keep dreaming.
◼ don't rush, go slowly, and be present
fairly self-explanatory. after all, where are we rushing to exactly? and what are we missing along the way? leo mentions the concept of giving equal weight to every action -- something introduced to him by a friend who happens to be a zen monk. i love the idea of this -- neither overdramatizing the big moments nor ignoring the little ones. paying attention to the spaces between activities. the commute to work. unloading the dishes. those 10 minutes under the covers just after the alarm goes off.

every moment has value. [source]
◼ basic rule: cause no harm
you may have picked up that i'm not a religious person. but if i did follow an organized religion, this rule would be at the very forefront [i think it's somewhere in those commandments somewhere, anyway!] <-- vintage 2004 post!

◼ applications
leo takes the above tenets and applies them very well to several realms: effortless parenting, effortless work, effortless relationships. while i maintain that nothing will ever truly be effort-free, i think he makes some excellent points in these chapters.

ideas that didn't resonate quite as strongly
☒ living without plans
i just don't know. i personally get true pleasure out of making plans -- and certain things, at least for me, require planning [for example, having healthy ingredients in the fridge in order to assemble a week's worth of dinners]. does this mean i'm not even supposed to make a massage appointment or schedule a trip to philadelphia to see family?

i think it's the expectations [see above] rather than the plans that truly cause trouble. i love to plan and i'm going to keep on planning. but i will pay attention to becoming to attached to specific end results.

☒ living without goals
i did like that he clarified himself a little [excerpt]:

My Definition of “Goal”: I don’t define goal as “any- thing you want to do”. I’m not talking about getting rid of all desires. I’m talking about letting go of predefined outcomes. So “goal” means “predefined outcome or destination”. If you start walking, without knowing where you’re going, you could say, “I have a goal of walking!” But you don’t know where you’re going. If instead you start walking to go to the store, that’s a walk with a goal. When people say, “You’re doing something, so therefore you have goals!”, my response is, “Yes, but I don’t know or care where it takes me.”

i still find it hard to rationalize both his goal-free stance along with his emphasis on developing habits.

needless to say, i'm not ditching the resolutions this year. but the focus on results is again something to think about.

☒ eating a vegan diet
this is a whole post in itself, but i'm not looking to change my [conscious] omnivorous ways any time soon.

off to round!
i have a great [and in some ways very zen . . . ] attending on with me this weekend and i'm actually looking forward to heading in to the hospital for a little bit. i have some loose plans for the day, but no expectations :) have a wonderful holiday if you are celebrating today and tomorrow!

weekday entropy

2011-12-23T07:14:00.004-05:00

riding the roller coaster
sometimes i feel like i spend the weekend diligently organizing/cleaning/setting up our lives, and then the week happens, and

BAM!!!
3D model of an exploding supernova by some very smart people
in the midst of the mess, i lose energy and motivation and i just don't breathe as easily. i find myself in a sulky holding pattern, just waiting for the next break so that i can rebuild everything again.

but the cycle can be broken: i just spent the last hour cleaning up the apartment and MAN, it felt good. i didn't get anything else accomplished this morning, but the kitchen is clean, my desk is clear, our bedroom is serene, and even my work bag is organized and free of clutter. i feel so much more ready to get on with the day. and i can honestly say that i feel happier!

note to self: do this more often.

december peace

2011-12-22T05:49:00.008-05:00

quiet season
it happens every year: beginning around december 20th, the hospital starts to just get . . . quiet. things begin to move more slowly. the parking garage empties a little as some [lucky] people head off on vacation. and all of the sudden, the pager stops beeping quite so incessantly. christmas magic!

it's surprising, in a way. working at a hospital, we deal with emergencies -- not anything that you'd necessarily expect to be impacted by something as trivial as the date on the calendar or a superfuntastic holiday coming up. but maybe holiday endorphins have healing properties, or the promise of pReSeNts! pushes our diabetics just a bit so that insulin is not forgotten. after all, no one wants to spend their holiday in the pediatric ICU dealing with DKA.* [including me].

don't get me wrong -- not everything shuts down. the NICU, for example, is pretty much the same as it is any day -- apparently premature babies don't get the memo about santa for at least a few months into post-gestational life. and therefore i will be getting calls about hypoglycemia and thyroid problems and adrenal insufficiency. but it won't be anything unmanageable, and sometimes coming into a hushed holiday hospital is almost a little bit . . . cozy.

so i actually like this time of year, and i have worked every christmas since 2007. we don't really celebrate [unless you count traditional indian takeout], so i feel it makes sense for me to let others who do have a wonderful holiday. and i don't work new year's, so it's a fine tradeoff for me.

* DKA = diabetic ketoacidosis = acute illness that happens primarily in type 1 diabetes in the context of not having enough insulin on board for whatever reason [insulin pump failure, a forgotten injection or 3, underlying other illness].

new food find
public service announcement: if you see this peachtree pimento cheddar spread at your grocery store, you should buy it.

i'm certainly not proclaiming it health food . . .

the stats wouldn't be bad, but the idea of a 1 tablespoon serving is laughable once you taste this stuff
ingredients pass muster, though!
this is not a official 'review'; i just bought this on a whim at whole foods last weekend. but seriously: SO GOOD! super-sharp cheddar flavor, just the right amount of saltiness, and piquant pimento pieces strewn throughout -- you can't go wrong. i ALMOST just had some for breakfast. [not quite though, because i have a sunflower seed butter addiction. but almost.]

in other news/links

♥ if i were actually training for something again, i would be all over this training diary designed by two professional runners [lauren fleshman and roisin mcgettigan]. so pretty + motivating.

♥ love this poem on the moment found on repsych.

♥ i am obsessed with these angora baby booties:

my sister sent me this picture, but isn't sure she'll have time to make them! AGHGHGHGHGH!

♥ recipage [developed by the lovely emily of daily garnish fame] is now free! i'm thinking of starting to use it -- partly just as an organizational tool for myself.

♥ quick business note: if you entered the spa gift card giveaway, i have been notified by blogher that the winning number [they pick it] will be sent to me on january 3rd.

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12.21.11

workout: nada. [tuesday i did 3.01 mi at 10:15/mi]. i'm starting to have some back pain -- thumbs down. perhaps i need to amp up the yoga . . .

dinner: an easy clean eating recipe from the jan/feb issue:

pork and carrot curry
probably would have been 'cleaner' without a million of the above-pictured crackers with pimento dip beforehand, but oh well.

espanol: check. reading: sorta check [i did it at work].

resolutions 2012 [part 2]

2011-12-21T06:22:00.014-05:00

[miss part 1 and love resolution-season like i do? it's here!]

the annual review
ahhh, for me, this is usually the least-fun part of the resolution process: reviewing the previous year's promises and celebrating success or admitting defeat. i hope that this year's new approach helps me focus a bit better, but last year i made 6 traditional 'january 1' declarations. here goes nothing . . .

#1: 30 minutes of endo studying/reading daily

i've been SO off and on with this one, but unfortunately i can't say that i consistently hit this target. more consistent studying is definitely something i would like to do in 2012, but i realize i may have to adjust my expectations a bit [perhaps dedicating 30 minutes while at work?], since after baby i'm pretty sure my home life will be VERY different.

grade: C

#2: workout reform [ie WAY less cardio/running for TTC purposes]

looking back, this photo was taken the day i ovulated prior to my BFP. coincidence or new fertility trick!?
it wasn't until january that i finally accepted a 10 mi/week limit to my running. to fill the void, i did lots of yoga [i still feel like blue point gets partial credit for this pregnancy!]. 4-miles became my 'long run' and in lieu of weekly distance, i became obsessed over side crow and headstand <-- evidence that i did eventually get the hang of it -- now hopefully i'll be able to do this again someday post-baby! this resolution was very hard for me but turned out to work out very well. i am proud of my non-activity!

grade: A+

#3: get out and do more!

in colorado springs with the lovely YPC! april 2011
hmm -- this one is harder to gauge, although looking back, i think i succeeded with this in 2011! over the past year, josh and i traveled to arizona [for a week] and the beach [for a weekend] -- not to mention our recent trip to miami for essentially a day. i went to colorado for work, philadelphia for fun [HLS!], and boston for a lovely reunion with my college girlfriends. we've had some fantastic dinners with friends -- both out and in. we've enjoyed exploring our new area [YEAHHHH downtown durham!], walking to local restaurants and the local movie theater. i saw girl talk and bon iver. i've gotten to hang out with both sides of the family. i'm sure we could do more, but i'm pretty satisfied with the current balance.

i would still like to see my sister more + make it out to raleigh!

grade: A-

#4: see an RD for my TTC issues and make necessary changes

as you all know -- SO glad i followed through with this [read details of my RD visit here].

grade: A

#5: participate in one service project this year
um. other than some monetary donations and organizing the reach out and read fundraising efforts last spring, i didn't really do this, and i have to say i'm a little embarrassed about it! i don't think i was specific enough in defining my goal.

but that doesn't mean i am giving up forever!

grade: D -- but with opportunity for extension.

#6: slow down and relax

ahh, forever a work in progress. but at least i'm still trying!

grade: A for effort, though not for execution.

well, that was fun. i am [as always] looking forward to starting anew with different strategies in 2012! how did your 2011 resolutions go? do you do a similar review of sorts? it can be painful, but is definitely helpful for me to see what went wrong -- and to appreciate that a lot went right! here's to growth, learning, laughter, and peace in the new year.

25 weeks + fiji dreams

2011-12-20T05:42:00.012-05:00

vacation envy
this morning, i awoke from a very vivid dream that josh and i had irresponsibly dropped everything [ie: took off of work without actual vacation!] to fly to fiji.

[source]
you know, just because.

the funny thing is that if i were not pregnant right now, we would be gearing up for a relaxing and luxurious week [or more] in hawaii in just a few weeks. when i was going through TTC-hell, i dangled this carrot as a consolation prize, thinking that at least i'd have SOMETHING to look forward to if things continued to go the way they were going [ie: not well]. we even booked our accomodations -- the same beautiful B&B we stayed at during our honeymoon.

now i'm carrying at least 13 inches and 1.5 lbs of baby, have given up every last vacation day between now and when i get a real job, and have swept all of the would-be travel cash into the essential day care fund.

i'm not exactly feeling the urge to throw on a bikini these days, either
. . . and i am TOTALLY thrilled about it! i would much, much [MUCHH] rather have it this way.

but it's still fun to dream about fiji. someday we will go!

25 weeks: official OB report
it's so funny -- i gear myself up for these appointments, and then they're over in less than 20 minutes. at the practice i go to, it's like this:

✔ leave urine sample. luckily, there's never really a time i DON'T have to go these days!

✔ weight/BP [always slightly nerve-wracking. what can i say? is there ANYONE who enjoys this?!]

✔ go to exam room and wait [usually quick, but sometimes the longest part of the whole process]

✔ OB comes in and does measurement and doppler

✔ "any questions"? [i usually can't think of anything legit to ask, really]

✔ the end.

they never ask me anything or address things like exercise or energy levels. i guess there just isn't time and they assume i'd bring something up if i had a concern? anyway, it doesn't leave me with much to report except the raw stats, which i have to assume are 'fine'.

stats at 25 weeks
weight: i'm now up 14 rather substantial-feeling lbs. at yesterday's visit, i was up just 2.6 lbs total over the past 4 weeks despite thanksgiving and ice cream and a ridiculously indulgent dinner saturday night. fine with me -- it balances out the slightly larger gain from the previous 4 weeks. i feel like i'm eating a lot -- kind of like marathon training but without the actual MARATHON TRAINING -- but i think i'm finally starting to trust that my body knows what it's doing.

BP: 126/76. i actually worry about this a little. my BP has been high-ish in the past [particularly on OCPs] so hopefully this is not the start of an upward trend. the OB didn't say anything about it, though.

doppler: little girl was beating away in the 150s as usual, and then gave the wand a swift kick for good measure.

fundal height: large and in charge -- i measured at 27.5 cm [the measurement in cm is supposed to approximate gestational age]! i KNEW my uterus seemed kind of big. i was assured that i was just 'on the upper end of normal' but of course now i'm envisioning gestational diabetes and the lovely chore of pushing out a 10 lb baby.

i am definitely happy to be in the "viability" stage, but let me tell you as a pediatric resident who has spent time in the NICU, i'm not going to truly relax until i hit 30 weeks or so! still, signs are looking like there's REALLY going to be a baby coming out of me in a few short months. things i am going to start doing . . .

★ making lists of things i think we'll want/need [and probably do a registry]

★ reading some baby-related material! [the no cry sleep solution, etc]

★ ???? not sure how else to prepare! any thoughts?

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12.19.11

workout: 30 minute power vinyasa yoga dvd. the bigger i get, the harder this gets! every squat and lunge i get into really makes me FEEL those 14 extra pounds. i can't believe that chataurangas used to feel EASY to me [well, at least until i did 8 million of them dave farmar-style].

dinner: leftovers for all [including pizza for me]. easy. cheesy. done.

espanol: check! started unit 3. it's getting harder!

endo: ehh, not really. i got home sort of late and only had time to spend a few minutes. but at least i tried.

from weekend to week

2011-12-19T06:22:00.008-05:00

weekend
miami was lovely, as usual. stepping off the plane to feel a tropical breeze in the middle of december is always welcome, even if the experience is short lived. after almost a decade of visiting miami beach [and associating it with carefree vacation time], it is starting to become a reality to me that we are going to be living there in just about a year and a half. i'm going to have to get used to balmy morning runs and a whole lot of sunscreen.

[source]
but this trip was more about family than it was about the sun. it was really wonderful getting to spend time with KK + pop-pop [josh's grandparents], even if the reasons that brought us down were more bitter than sweet. he is feeling better now but still recuperating from a long hospital stay, so we spent all afternoon in their condo, discussing everything from old memories [baby-care in the pre-disposable-diaper age!] to new horizons [stem-cell infusions for heart failure].

i didn't take a single picture. i sort of decided that i didn't want to feel like i was 'covering' the trip for my blog -- turning my daily discipline into a chore of sorts and perhaps taking away from my true presence during the [extremely] short interlude. that sounds great, but in reality i absolutely wish i had brought my camera -- it made me realize that my vacation recaps and photo-sharing is absolutely just as much for me as it is for "the blog" [as an abstract entity] or for you, the readers.

✰ insert pretend picture of josh, me, his parents + grandparents, all sitting around laughing while watching boats speed by on the bay

✰ insert nonexistent picture of me with my adorable niece + nephew, playing with a little mermaid stickerbook [instant gift hit!] and going through an intricately-orchestrated bedtime + bath routine together

✰ insert picture of josh looking a little shellshocked, suddenly realizing that pretty soon we're going to be going through our OWN bedtime routine

✰ insert photo of an amazing meal at tudor house on the night before chef geoffrey zakarian won on the next iron chef

so ummm, at least i know that for next time, the camera will come along even if the laptop doesn't! and i will remember that lacking photo evidence does not take away from the memories of precious time spent with family.

new week
if flying were much cheaper and more environmentally sound, i would take 24 hour trips to various destinations all the time. it was pretty crazy and amazing to spend a day with family in a completely different place and still arrive home on sunday in time to do laundry and buy groceries.

given this, i feel ready for the week. i'm starting yet another new project . . .

a newcomer has made it to the active book stack on my desk
the kitchen is stocked with ingredients for future dinners, plus plenty of lunch leftovers . . .

last night's healthy taco bowl from the current issue of clean eating
josh and i had some essential couch time after we landed, and i managed a run outside while it was still light out. really, i feel like this past weekend had more in it than would seem to fit into just 48 hours or so.

off to practice some spanish, do a little yoga, and then attend my last [i think?] 2nd tri OB appointment. bring on the week!

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12.18.11

workout: an incredibly refreshing 3.73 mi at 10:13 pace. i am still feeling quite good out there at 25 weeks! 7-day rundown:

not so balanced -- i had been better about weights and yoga until this past week. but i'm still happy with the running and my overall activity level.

dinners: this week's meals will be brought to you by the current issue of CE -- although i'm a little sad because there are no easy links to share recipes here! i was reading the jan/feb issue on the flight back and found a number of recipes to try. last night's taco bowl [shown in the post above] was excellent - i'm already excited about eating leftovers for lunch.

off to miami

2011-12-17T07:09:00.003-05:00

but only for ~24 hours
i didn't mention this because it was a pretty last-minute arrangement, but josh and i are off to miami this weekend. pop-pop [josh's grandfather -- yes, that's his official title] is having some pretty serious health issues, so we are going to spend time with him and the rest of the family.

[source]
and obviously we'll be tearing up south beach in risqué clubwear as well. [ <-- ha AS IF. aside from his sister's bachelorette party, this has never happened, so i can't even use pregnancy as an excuse.]

that's about all i have time to say this morning since we have about 45 minutes to pack + shower. have a wonderful weekend!

time

2011-12-16T06:09:00.004-05:00

Hence, there is a time to go ahead and a time to stay behind.

There is a time to breathe easy and a time to breathe hard.

There is a time to be vigorous and a time to be gentle.

There is a time to gather and a time to release.

Can you see things as they are

And let them be all on their own?

~ Lao-tzu

this morning
i needed a little more time to sleep, and now i need some time to clean up our apartment. but i will leave you with a few things to do if you have some extra time to play with . . .

♥ the fabulous shelby is giving away a book called brewed awakening, a guide to the craft beer revolution.

♥ on the absolute opposite end of the spectrum, the fitnessista is giving away a snoogle [nope, still haven't bought one yet.]

of course, i entered both.

♥ there's still time to enter the dove spa-finder giveaway for a $100 gift card redeemable at many spas and salons. and your chances are still quite good!

all right, off to clean and then run. all in good time, i suppose. happy friday!

resolutions 2012 [part 1] + 24 weeks

2011-12-15T06:02:00.008-05:00

thoughts about resolutions
i have been doing a lot of thinking about my typical january resolutions. i am completely guilty of the following december sins:

✔ making far too many resolutions at once. examples: 16 in 2006, 18 in 2008. i've gotten a bit better about this over the years, but i still think i'd be better off narrowing my focus.

✔ drafting the same resolutions every year without really changing my plan of attack. if it didn't work in 2011, why would things magically change in 2012?

✔ resolving to do things that are really not under my control. this year, i'd love to resolve to get a job for when i finish fellowship, but in reality this depends more on the market/availability than anything else! instead, it would be more realistic to resolve to send out resumes early; be proactive about making phone contacts; etc.

✔ tracking accomplishments rather than efforts -- and then getting discouraged.

don't get me wrong - there are some instances where it is absolutely necessary to track accomplishments. when i've had a big intimidating project with a due date [big and pricey exam*, grant, paper draft], this is the way i tend to go -- and it works.

but when it's a just-for-me endeavor?

i find that tracking effort [spanish example below!] is much more satisfying.

it's not perfect, but it's definitely something!
and in contrast, here's my sad little accomplishment-based list for after-work studying:

i swear i didn't quit in october
looks pretty pathetic, doesn't it? and while the truth is i'm sure i could have put in more effort, it actually hasn't been such a wash. the chapters just took much longer than i anticipated, and i decided not to spend evenings on call hunkered down over a textbook [the pager stresses me out enough].

i hinted at this previously, but i think i am going to go with a one resolution per month format in 2012. good old leo would encourage me to quit altogether, but i continue to disagree wholeheartedly with his goal-free proselytizing. what do you think?

* congrats to anyone reading this received word about passing the pediatrics boards yesterday! such a wonderful feeling, right!?

24 weeks
i can't believe that just over 6 weeks ago it was halloween and i looked like this:

~18 weeks
and now we're headed into the holidays and i look like THIS:

~24 weeks
so far, i am having a very uneventful pregnancy -- definitely the most important part. but lately, a few ~~annoyances~~ pregnancy side effects have begun cropping up as i creep towards the finish line of the 2nd tri.

mood swings: too many tears. seriously.

bladder pressure: oddly, i am able to go longer at night without getting up compared to the first trimester! but during the day, i tend to have to stop at the bathroom at least once an hour. and honestly, i'm not even drinking that much throughout the day -- i should probably be going even more!

slowdown: my runs are definitely slowing down -- i did 3.1 miles at 10:30/mi pace on tuesday. pretty soon, i am guessing i will be adding some walking intervals to my runs. i am still feeling good, though! and i can just still zip my favorite winter running top. luckily, when it ceases to fit i have a cheap solution: JOSH'S CLOSET. at this point, i really don't feel like i need some fancy maternity techware for my 30 minute AM jaunts. however, this horrifying item may become a necessity at some point. we'll just have to see . . .

cravings: are pretty much gone. as i mentioned before, i just need food these days -- i'm not that picky. i ate the same fish chowder for dinner the last 3 nights in a row [never pictured because it was NOT pretty!]. i am loving the product below this week, but i'm sure i'd be a huge fan whether or not my uterus was inhabited.

a delicious way to get those few extra allotted pregnancy calories . . .
weight: uhhh, speaking of calories, right? i don't have my official appointment until next week, but i think i'm up about 13 lbs. maybe 14. it definitely feels like a lot, but according to the dreaded calculator, this is normal and right on track.

missing: wine. holiday parties without a glass of red [. . . or 3?] -- not the same.

wearing: what seems like the same things all the time -- i guess this is why women get sick of maternity wear! and i have to admit i'm nervous as to how long my current outfits will last [ie, will i outgrow them in a few weeks?]. i'm hoping i can at least get to the end of january, when i will retreat back to the lab. i can then wear the same thing daily and probably no one will notice or care!

new baby acquisition: thanks to my wonderful west coast friend sara, i now have an itzbeen baby timer!

ahhh so exciting! i have no doubt that i will use this in the newborn period. [bonus: i could see this coming in handy for contractions as well :) ].

-----------------------------------------------------------------------------

12.14.11

workout: 30 minutes on the elliptical

dinner: as i mentioned above -- some more never-ending fish chowder. for the third night in a row. tonight, we're just going to have to move on.

espanol: check. um, mi suéter es gris. [true statement.]

reading: 25 minutes on glycogen storage and fatty acid oxidation disorders. i'm so glad i'm not a metabolism expert -- that stuff makes my head spin.

wish list 2011

2011-12-14T05:38:00.006-05:00

this year i want a lot of things.
inconveniently, none of them are for sale.

i would like . . .

✔ for my family and friends to be healthy and happy. [this includes family members who are not born yet!]

can't believe this was 3 months ago already . . .
✔ to be more calm and less judgmental.

✔ to learn a lot, and feel engaged in my career.

✔ to not sustain a fourth-degree tear.

✔ to never be rushed or in a hurry.

✔ to be fully awake. and appreciate something beautiful every day.

✔ to connect frequently and meaningfully with family and friends.

✔ to feel vibrant and healthy. [extra bonus if i can feel attractive, too.]

✔ to become mother and father, but also remain husband and wife

love you baby
✔ to be there for others who need me.

yep, that's pretty much it. i'm not going to claim that worldlier pursuits haven't crossed my mind at all . . .

just browsing. so cute.
but above are the essentials.

challenge

2011-12-13T05:59:00.002-05:00

no one would call me mild-mannered. or quiet. or unflappable. i don't have even a hint of southern grace in me despite living in north carolina for the last nine and a half years.

i write a lot about mindfulness and zen and remaining present and staying calm.

that is because those things are incredibly challenging for me.

particularly in certain situations -- some of which are unavoidable, especially in my line of work.

i don't really want to go into any more detail, but this has been on my mind for a few days now and is weighing on me pretty heavily. after all, it's easy to fix a knowledge deficit or a bad habit. this feels more like a character flaw -- which i suppose it is, despite some of my efforts to fight it. and that hurts.

on the up-side, i tend to wear my emotions on my sleeve, so if i'm happy i'm pretty darn exuberant! i have a lot of energy. i often form strong opinions. i think i am pretty reliable [read: obsessive] when it comes to the details of my job. i care about my patients and have wonderful relationships with a number of families.

clearly, no one is perfect [especially me]. but i try pretty hard at life. and i will work on this.

i'll take it

2011-12-12T06:10:00.007-05:00

as call weekends go . . .
after a rough start, this on-page weekend turned out to be quite nice. it included:

✰ time for gift-buying! [even if most of it was online]
✰ plenty of quiet time at home to get housework done
✰ time to read more about the music i've been loving lately and to finally delve into 1Q84
✰ a day away from the hospital [we didn't need to round in-house yesterday!]
✰ 2 holiday parties
✰ 1 cool-but-sunny run and 1 relaxing gym session
✰ a conversation with my parents <-- sunday essential
✰ 3 nights of uninterrupted sleep [ <-- practically unprecedented for weekend call]
✰ a delicious brunch out:

ham & gruyere omelette; pommes frites; salad from vin rouge
the above was great, although i ordered mushroom [not ham] . . . but was then too hungry to wait for a replacement! i also chose to fill up on their bread rather than the fries, although both were delicious.

this picture does not do their chewy crusty french bread justice. it is my favorite!
i also had a few moments to do some shots of the ever-expanding bump. 24 weeks, baby:

the bump is taking over
seriously, i feel like i look farther along, but it is what it is! ahh, the plight of a short pregnant woman.

yet another stocking stuffer idea . . .
how cute are these kate spade list pads!?

there's the short list version in pink:

from see jane work, $7
and a longer version in cheery yellow:

also from see jane work, $9
perfect for coworkers or friends with lots to juggle.

----------------------------------------------------------------------------

12.11.11

weekly workout rundown: good balance - especially for a call week:

espanol: confession: i only hit 3/5 days last week. about to dive in right now.

reading: very little, but i am okay with that while on call.

evening resolution: still needs work. more on that tomorrow!

nice things

2011-12-11T08:40:00.005-05:00

music

of monsters and men, "little talks"
this icelandic group hasn't released their album in the US yet [and i can't find it legally online!] but you can hear a number of live tracks on npr. i can't wait for the full release! there's definitely something arcade fire-like in their execution, but the delivery is less orchestral and a bit more intimate.

lana del rey, "video games"
a beautiful girl with a voice to match.

edward sharpe and the magnetic zeros, "home"
this isn't a new song, but i smile every time it comes on my favorite XM station [spectrum] . . . which is quite a lot!

paper
i've mentioned online retailer invite.L before, but if you're in the market for super-cute small gifts, it's definitely worth checking out!

timetable sticky notes have built-in checkboxes -- love. $6.
felt bag-in-bag organizer, $27. sometimes my orlas DO seem like bottomless pits . . .
they also have cute, functional, and reasonably-priced iPad and laptop sleeves.

gingham-checked washi tape! $6/roll.
call
so far it has been a pretty light weekend -- and i plowed through my list yesterday [still have two more gifts to buy, though]. <-- that sounds more impressive than it is; my list wasn't super-long as gifts for everyone are not necessarily in our family tradition. the kids [ie, my nieces + nephew] are the most important!

your favorites: any book/movie/music/gift recs you are loving lately?

on a similar note, i can't wait for yearly 'top 10' lists to come out. i'm a sucker for superlatives! and lists, of course.

surfing a treacherous sea

2011-12-10T08:41:00.006-05:00

the tempest
i feel like i've been riding an emotional roller coaster lately. things that in the past might have left me miffed or a little disappointed are making me sob even while the logical part of my mind watches in disbelief [and disapproval]. a phone conversation with a parent that went south yesterday while on call caused me to spend hours worrying about my competency as a physician -- even my worth as a person. and then, i of course worried about the effects of all of these histrionics on the baby. oh god, was that a contraction!?

[source]
it's such a cliché, but i'm sorry: i have to believe it's the pregnancy. while i haven't suffered from terrible fogginess or memory problems [yet], i feel like i'm always just one little event away from a crying spell. it's not like this is a new phenomenon; it's just that [of course!] i didn't think it would happen to me.

after the storm
well, i guess i should get on with life. try to learn from the heightened emotions -- maybe it's training so that i emerge as a steady oasis of calm after our baby is born, and therefore be a better parent. all i know is that i would like for today to be as calm and quiet as possible.

luckily, i find folding warm laundry to be lovely and therapeutic
not sure the vascular surgery holiday party tonight is going to meet those criteria, but we'll see.

resolution revolution

2011-12-09T06:35:00.006-05:00

a habit of resolving
if there's one habit that is firmly implanted in my soul, it's that of making resolutions every single year -- although of course, they are carried out with variable success. i love spending some of december reflecting on what worked / what didn't from the prior year's resolutions list, and more of that is to come! but i think that my format needs to change a little bit. maybe it's the influence of leo babauta, but i'm beginning to believe that one change at a time is the way to go.

so: i'm thinking about focusing on one thing [small or large!] each month in the coming year. this leaves more room for flexibility [i'm having a hard time predicting what i will want to focus on post-baby!] and perhaps the increased focus might lead to more success with some of my goals.

of course, the little blue notebook has some ideas in it already! i will definitely share more in the coming weeks.

DOING vs NOT-DOING
i have noticed that i tend to struggle a lot more with negative resolutions compared to positive ones. this makes sense; all it takes is a moment of weakness and a negative resolution is 'broken', whereas a positive one just requires one moment [well, sometimes several] of strength.

examples of negative resolutions
✔ only use internet for XYZ minutes/day [this one is SO HARD FOR ME!]
✔ stop overeating at parties or restaurants
✔ avoid gossipping at work

examples of positive resolutions
✔ work on spanish for 15 minutes daily [this one i've done pretty well with!]
✔ drink XYZ ounces of water/day
✔ have at least one date night with significant other / week

sometimes the same goal can even be framed in two different ways, one positive and one negative. ie: "stop getting take-out on weeknights" vs. "plan for and cook dinner at home on weeknights"; "stop rushing in the morning" vs. "cultivate and follow a relaxed morning routine".

just because a resolution is positive doesn't make it a good one -- at one point, i 'resolved' to get pregnant in 2010, and COME ON NOW. that's just a setup for disappointment and pain. and there is certainly a place for negative resolutions -- i am not sure how to frame some of the 'negative things i'd like to accomplish in positive terms. but i definitely think that the negatives are harder!

yep, struggling a little here . . .
thoughts/experiences with resolutions -- and which kinds of goals do you tend to make? one thing i like about the 10/100 [or 100/1000] style of goal-setting is that this exercise tends to generate positive [and often fun-to-fulfill] goals.

ps
don't forget to enter the dove spa-finder gift card giveaway -- your chances are still pretty fantastic! and i selfishly want someone who reads regularly to win :)

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12.8.11

workout: 3.06 mi, 10:15/mi pace. funny, it didn't feel much slower than tuesday's run which was just under 10:00/mi. but really i am just happy to be running! i anticipate that at some point as i grow bigger, i will move towards a run/walk pattern, but it definitely feels good to still be out there.

from wednedsay night: last night we celebrated josh's birthday at his absolute favorite durham restaurant, rue cler. it was a lovely meal [as always], but no photos were taken. but: here's wednesday night's stir-fry . . .

soy-sesame marinated tofu with vegetables and shiitake mushrooms
the actual recipe called for the tofu to be left in large slabs and grilled like "steaks", but who are they kidding? tofu is not steak and i'd rather it just be . . . tofu. so instead of getting the grill pan dirty, i just marinated it, cubed it, and threw it in with the veg at the end of cooking. it worked fine.

spanish: agh, after all that talk above? i actually missed yesterday! but i'm getting back on the wagon immediately.

reading: as previously, i consider myself somewhat exempt from this on call weeks. the pager hasn't been TOO bad, though!

37

2011-12-08T08:12:00.001-05:00

it's a prime number!

in fact, it's "a prime number, the fifth lucky prime, the first irregular prime, the third unique prime and the third cuban prime" -- according to wikipedia, that is.

it is also josh's NEW OFFICIAL AGE as of today [yep, i'm 6 years younger], and i'm pretty sure it's going to be an eventful year.

YES, maybe even that eventful!

don't look so shocked.

that's better.

36 was good. i mean, there were some lovely times . . .

from wilmington NC . . .
to sedona, AZ

often involving food, but always with both of us together.

i'm not saying that EVERYTHING was easy . . .

and sometimes you were tired.

but i expect that this year of your life will be even more thrilling, adventurous -- and exhausting, too. but special and awesome. and worth it.

love you! happy birthday from me . . . and the blog :)

link luv: december

2011-12-07T06:29:00.005-05:00

hi
i'm glad yesterday's post on hypothalamic anemorrhea was helpful to some of you! i put off writing it because it seemed daunting, but once i got into the swing of things it was a lot of fun sharing what i've learned [both at work, and personally]. because it took quite some time to write, i'm giving myself a bit of a break today and letting some of my internet favorites do the work for me. let the link luv begin!

recently spotted
♥ the happiness of introverts. even though i'm not an introvert, i enjoyed this short piece on some of the different kinds of happiness -- including a few less obvious forms.

♥ review of the super-comprensive collins 24-hour home and work diary on plannerisms. a hardcore planner reviewed by a hardcore planner fanatic! while i wouldn't want to carry around so much i'm sure that it's someone else's dream diary.

♥ more on the good ol' HP about decision making styles. i'm a satisficer all the way! you?

♥ a list of favorite reference books from angeliki of repsych. i basically want to read them all!

also
i am contemplating a body pillow. as i mentioned previously, i was staunchly anti-pillow before pregnancy. if one of josh's 4 even attempted to get in my way, i'd often throw it on the ground in my sleep. now, i've claimed 2 and often wish for a third. 1-2 go under my head and another goes to the side so that i can sort of half-lean on it and pretend that i'm KIND OF sleeping face down.

so um . . . snoogle or my brest friend [shown below]?

i could go by which name is more ridiculous, but it would still be a draw.

---------------------------------------------------------------------------------------

12.6.11

workout: 3.06 mi, 9:57/mi

spicy shrimp noodle bowl
this soup was good in concept and i really liked the broth [you boil the shrimp tails/shells in hot water, broth, and clam juice to make a delicious salty base]. however, it would have been better if:

-- i hadn't gotten paged and forgotten to take it off of the burner while i had a scintillating conversation with a parent about how their 6 month old looked like he might vomit, but hadn't

-- i had used thicker + heartier noodles [ie udon or soba] instead of super-thin rice sticks

ahh well, it was dinner.

espanol: si

reading: no, due to a later night at work and work to do once i got home. but it was okay.

the hypothalamic amenorrhea post

2011-12-06T05:35:00.025-05:00

the professional perspective
first: a little background

from endotext.org
okay, don't freak out! seriously. all i wanted to illustrate with the crazy scheme on that chart is that the controls of reproductive function are complicated. your ovaries aren't just on autopilot; there are inputs from the brain and the body that are critical for regulation of functions such as ovulation and menstruation.

the hypothalamus is an area of the brain that receives inputs from the rest of the brain as well as hormonal signals from the body [estrogen, leptin, and progesterone -- just to name a few of these influences]. to simplify things, depending on what the input signals say, the hypothalamus will either act in favor of or against ovulation [and therefore fertility].

the hypothalamus gets all of this power because pulsatile release of a hormone called GnRH is needed to stimulate the pituitary to make LH and FSH in a pattern that will lead to ovulation. you can see a schematic of this below, or you can just take my word for it.

GnRH, LH, FSH, and ovarian hormones: on an ideal monthly cycle
if you think about it from an evolutionary perspective, this switch makes absolute sense! if ms. cavewoman was living in less-than-ideal conditions [ie, starvation / very high stress / illness], WHY would she want to pour precious energy and resources into the costly process of ovulation and then reproduction? an undernourished and unhealthy female is unlikely to successfully grow and raise an offspring, so it would be a wasteful endeavor to just let it happen willy-nilly.

some things that the hypothalamus pays attention to
✰ fat stores. via hormones like leptin and estrogen [yes, fat makes estrogen!], the body is able to 'tell' the brain what the nutrient situation is like. too little leptin --> a hypothalamus that is not going to be pro-ovulation. this means that BMI may be less important than overall body fat percentage when it comes to fertility [although someone with a BMI of 16 is unlikely to have enough fat to procreate no matter how you slice it].

✰ illness. if a person is chronically ill [poorly-controlled diabetes; inflammatory bowel disease; cancer; lupus; etc], then this can certainly shut things down -- another smart evolutionary move. it absolutely does not mean one CANNOT get pregnant while sick, but it does make it less likely.

✰ stress. 'stress' is a widely used and very vague term these days. but it's true: enough of certain types of stress can certainly blunt hypothalamic pulsatility, particularly if one's hypothalamic axis tends to be on the more sensitive side.

✰ exercise. so that 18 mile long run? it might not have felt like stress to you, but that doesn't mean the hypothalamus doesn't view things differently. after all, the primitive brain centers don't get that you're just training for fun -- they just see a whole lot of very high-intensity activity. were you running from a saber-toothed tiger? or fleeing an unsafe living area? either way, it's a whole lot of energy expenditure and doesn't exactly reassure the hypothalamus that it's baby-making time.

2 months ago, i gave a presentation on HA which focused on a new england journal study recently released; those with journal access and curiosity can see it here. basically, this study aimed to identify genes in patients with what they called functional hypothalamic amenorrhea to find out if there are genetic factors that might underlie susceptibility to this condition.

in other words, they wanted to figure out why some women are more vulnerable to this than others -- what makes some hypothalamuses [hypothalami!??] more sensitive than others. ie, how it is possible that victoria beckham has managed to procreate 4 times . . .

although of course there is no way of knowing what went into these pregnancies and i am not going to speculate!
in the end, the article DID find some clues as to the genetic basis of hypothalamic amenorrhea -- though their findings were just the beginning. however, what i would like to highlight are the criteria these authors used to put someone in the HA category, because in my own experience clinicians and patients are NOT always on the lookout for this condition unless it's really obvious [ie, 90-lb ballerina with 3 stress fractures].

HA criteria used in the NEJM study
1. Secondary amenorrhea x 6 months or more

2. Low or normal gonadotropin levels [a fancy term for the pituitary hormones LH and FSH]. i've heard many people say they don't think that running or exercise is an issue because their LH and FSH were in the 'normal range'. i believe that HA is a spectrum, and in some ways it's the hardest for those who are not at the severe end because it's not so clear what to do -- but normal LH and FSH do not mean a normally-functioning hypothalamic-pituitary-gonadal axis. in this study, the average LH and FSH in the HA group were 4.1 and 6.3 mIU/ml, respectively.

3. Low serum estradiol levels. or low-ISH, really, based on the numbers they provided. unfortunately, the study does not mention how low their specific cutoffs were -- and the average value in their HA group was 39 pg/ml. this isn't a level that would necessarily be called out as 'abnormal', but apparently it's low enough [at least according to NEJM].

4. Normal neuroimaging, no PCOS symptoms/labs

5. One or more predisposing factors below:

Exercise >5 hours/week
History of loss of >15% body weight
Subclinical eating disorder on Eating Attitudes Test

this was not among the criteria, but of note the average BMI for this group was 19.4. ie, on the low end, but not an unhealthy BMI by official standards!

in the end, using the above criteria, the study identified a decent proportion of patients [7 out of 55] with mutations in some of the genes involved in hypothalamic control, while NO mutations were found in a control group of women who had HA risk factors [ie, were exercising > 5 hours/week] but were ovulating normally. this doesn't mean that we completely understand what may make you more vulnerable to HA than your running partner, but it hints that there's probably a genetic basis.

ie: to some extent, it's the luck of the draw.

the personal perspective
i'm not going to rehash my entire TTC saga -- it's here after all [and you all know the happy ending]. but here are some things i WISH i had known during my experience with infertility, which i now believe was at least in part secondary to hypothalamic dysfunction. after all, for over a year and a half i easily met the criteria in this study: i had complete amenorrhea with labs and BMI that fit the above profile almost exactly, and i was exceeding 5 hours/week of exercise on a regular basis. [of note, that may sound like a lot, but even an intermediate half-marathon training plan will often approach that amount, especially if you add in weights/stretching and include less intense exercise in the total.]

✔ this is very common. i often felt like the odd one out with my issues -- after all, i was not extremely thin nor a 'real' athlete -- i was just recreational! however, there is more and more research pointing to evidence for ovulatory dysfunction [both amenorrhea and more subtle phenotypes] in women who exercise more. and an astute reader [and now friend] led me at some point to this hypothalamic amenorrhea message board, which helped me realize that i was not alone. i definitely recommend checking it out if you are in a similar situation.

✔ the world won't end if you run less! and, you can often still enjoy SOME exercise while bringing things to a level that makes your hypothalamus happy. i found solace in yoga [fun] and a very reduced [but still-present] running load. at one point, i was attending vinyasa classes 2-4 times/week and running 2-3 times/week -- 3 miles at a time max. i was never completely inactive, but the changes were apparently enough for my body to respond*

✔ a little weight gain is not the end of the world either -- and it might help. actually, to this day i have no idea which factor was more important: the change in my workouts, or the ~8 lbs i purposefully gained [mostly just by not changing my eating much with the reduced activity] to bring my BMI up to around 21. i am not going to lie: it was not fun growing out of some of my own clothes. but in the end it was 100% worth it. i promise.

✔ you may have to take matters into your own hands. this one was very hard for me -- after all, i am a medical professional -- in the field of endocrinology -- so i wanted to trust the experts! i saw a reproductive endocrinologist through all of this who never made a concrete suggestion to me regarding weight and/or exercise, even as i failed to respond to multiple rounds of clomid in a row. i suppose she felt that my activity/weight did not put me in the obvious HA category, and thought i had some other issue, but i believe that the fact that i only started ovulating consistently with after the above changes -- even with medication -- tells most of my story. given how much of a problem obesity is in our society [and in medicine], i think it is hard for doctors to tell someone with a 'normal' BMI to gain weight or cut down on exercise.

after i did finally get pregnant, she made some remark to me that she got pregnant when she was injured and couldn't run [this physician happens to be quite thin]. umm, not so helpful AFTER THE FACT. i can't begrudge her too much, because hey -- now i'm hanging out at 23 weeks! but i wish i had gotten more feedback on this early on.

* although i did get pregnant while taking letrozole, i did not consistently respond to fertility medications until making the above changes. and i still wonder if i could have done it all-natural -- however, at that point my mental state was a mess and i wanted to hurry things up and be proactive as much as i could. i do not regret this one bit!

whew!
okay, i hope that was helpful and not just wayyyyy too much! please note that i am not offering individualized advice in the above -- obviously, every case is different! but the above is some background [through the eyes of a pediatric endocrinology fellow] and then my own experiences. feel free to share your own similar or conflicting findings here, or email me if you have questions [although again -- obviously, i cannot give out official medical advice!].

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12.5.11

workout: tracey mallett pregnancy fitness dvd. cheesy but i sort of like it!

monday classic i could pretend that i turn to amy's pizza on many mondays because it's the ONLY convenient option, but the truth is . . . i just kinda like it. it's comfort food to me at this point!

i took things up a [minor] notch last night and accompanied the usual with a west-coast-themed salad: spinach, tomatoes, avocado, cashews, and raisins, all in a vinaigrette made with a splash of honey.

tonight i'll christen our new apartment kitchen with its first real home-cooked meal.

spanish: si

reading: check -- yes even on call. the pager was pretty quiet, so i took advantage.

patience

2011-12-05T06:20:00.004-05:00

full week
i know this week will be a challenge. beginning at 8am, i will be on the pager for another 177 hours. but especially given recent events, i am trying very hard to

a) keep perspective

and

b) see this as an opportunity.

practicing patience
my due date is less than 4 months away. and i know that from the moment baby SHU emerges in her bald-headed glory [ <-- just a guess; neither josh nor i began with much hair], so many things are going to change. i am a person who likes control -- schedules, lists, and the like -- but i'm preparing to surrender this. babies do not follow templates or bow to timetables . . . and neither do toddlers or teenagers, for that matter. so i'm going to have to learn to go with the flow and be patient.

i loved this passage i read yesterday in jon kabat-zinn's wherever you go, there you are:

Patience is an ever present alternative to the mind's endemic restlessness an impatience. Scratch the surface of impatience and what you will find lying beneath it, subtly or not so subtly, is anger. It's the strong energy of not wanting things to be the way they are an blaming someone (often yourself) or something for it.

i know that anger. it happens when the pager rings for the 7th time when you JUST WANT TO SLEEP and you start cursing the world, including all of the little kids out there with endocrine issues and of course yourself, for getting you into the situation.

by the light of day, you can look back and see that the anger was misplaced, but it's oh-so-hard to cultivate patience inside of that moment, when it is needed most.

this week, i will try to channel the patience that i have observed in some of my most inspiring colleagues [including the one who was lost last week].

i sign on in 76 minutes. here goes nothing!

weekend highlights
as i mentioned yesterday, the past few days were tiring on several levels, but i do not want to paint a woe-is-me sort of picture. i was affected by last week's tragic loss, but my heart goes out to my colleague's family and close friends who are suffering more than i can even imagine.

we are now moved into what josh and i consider to be the nicest dwelling we've ever lived, and the move itself was actually pretty easy. our new space is fairly neat and functional already, aside from our future nursery [it's currently a makeshift office for josh, but he knows those days are numbered]. we ate THIS on saturday night:

snow crab, i love you
we got plenty of sleep, and we got to spend a good deal of time together -- which always makes things better. how can i complain?!

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12.4.11

workouts from week 22

cooking no sunday dinner this time -- we hit up nanataco for a super-late lunch [like, 3 pm] and basically took care of 2 meals in one.

just checking in

2011-12-04T19:15:00.002-05:00

because i feel like i KNOW so many of you and i don't want anyone to worry! it has just been an emotionally and somewhat physically exhausting weekend.

move went well [TROSA did a fantastic job again].

memorial service today was beautiful but i am not sure any of us feel any real closure just yet. or if we ever will.

tomorrow is a new week -- i'm on call, but totally fine with it. perspective.

back tomorrow . . .

xo,

SHU

shock

2011-12-03T06:56:00.002-05:00

i walked into work yesterday to find out that one of my colleagues -- a talented person that i liked and respected very much -- had passed away. i don't feel like the rest of the story is mine to tell, but it made me cry and then realize how lucky i am, once again.

it made me want to hug my loved ones close.

it made me think about how interactions tend to happen at work, and always strive for kindness and patience, even when it isn't always easy.

and it is just another reminder [more powerful than a dream this time] of how precious every moment is.

* * * * * *

time to move down the hall. i hope everyone reading has a wonderful saturday full of love and peace.

i love lists

2011-12-02T06:05:00.007-05:00

december goal: taking back the evenings
straight from the pages of the little blue notebook . . .

defining the goal
making sure it's MICRO-style
the obligatory checklist
in writing?!
skeptics may wonder why i take time to write all of these things down, or why i gravitate towards cute little charts and checkboxes.

i may be crazy and a little bit on the compulsive side. but you know what? IT WORKS.

race training plans [back when i used to run for real. i'm sure this was a super-light week.]

massive and intimidating grant-writing checklists.

writing my first 'real' journal article while fighting the urge to dry-heave.

board prep.

learning spanish.

and at the ripe old age of 31, i really don't mind if some people might think i'm ridiculous. i will stand by my checklists + notebooks with pride!

happy december! anyone else have a goal for the month?

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12.1.11

workout: 31 min run, 3.03 mi [10:17/mi ave] in 30-degree temps. probably the coldest run of the season so far, but it definitely wasn't bad.

puttanesca . . . or whatever
this recipe was kind of blah. it probably didn't help that i subbed sardines for anchovies [they were out at the store].

whole grain spaghetti with broccoli, olives, sardines, tomatoes, and parmesan
see, it doesn't even sound that good. and then, i accidentally [really - it WAS an accident] left it out overnight rendering several servings of leftovers unsuitable for consumption. ahh well, at least it wasn't something i loved in the first place!

spanish: si.

reading: more hyperglycemia/hyperinsulinism. i finally understand GLUD1 mutations.

22 weeks!

2011-12-01T05:35:00.007-05:00

past the halfway point
over the past few weeks, there have been a number of changes. even though our baby hasn't made it to potential viability just yet [and i don't even want to think about the possibility of her emerging any time soon], i feel like i am getting somewhere with this gestation.

i look pregnant. finally, i believe i have reached the completely unambiguous stage. strangers are asking me when i am due, and older women are giving me this weird kind smile that looks to be half knowing support and half pity.

also, my hair is obscenely long. i need to fix this -- just a trim, though
i'm starting to FEEL pregnant again.

during the first trimester, i felt something, though at times it seemed more like the stomach flu and a hangover than a baby growing inside. then at around 13-14 weeks, my symptoms seemed to vanish and i felt completely fabulous [and normal].

now -- i'm starting to just feel bigger, and i think the weight is starting to affect my posture and energy level a bit. i'm still running, but [other than last week's race, for which i must have had a magic burst of energy] i'm typically over the 10:00/mi mark. don't get me wrong -- i'm completely happy with that and still thrilled to be running at all!

i have mild lower back pain when i stand too long and i've started to sleep with a million pillows [CRAZY because before i never allowed a single one near me -- not even under my head!].

i have nosebleeds occasionally and i get random attacks of itchiness that never occurred before. and the best new symptom? i can feel our baby moving around ALL THE TIME now! josh even got to feel from the outside over the weekend while we were lying around watching movies. love it.

the rundown

new cravings: um, just food in general. i've been super-hungry this week. i'm trying to at least keep it fairly healthy!

baby purchases: still only her toms! i haven't been able to bring myself to buy any practical things yet. i figure we have plenty of time. although the sale-priced BOB has been tempting . . .

once we move this weekend [down the hall], josh and i will start planning what to put in our nursery. i'm anticipating a trip to IKEA will be in order!

weight gained: i think around 12 lbs at 22 weeks. i sort of can't imagine what i will feel like when the total is more than double that, but i think i already get why women at the end of pregnancy are ready for that baby to come OUT!

current dilemma: private cord blood banking or no? it's rather pricey, and i have gotten mixed answers from the veteran new moms that i have asked.

name: i have one i use in my head all the time, but i'm still not 100% and josh has yet to commit. i might submit something to swistle although i am guessing they get FAR more requests than they can handle.

baby books read: 0. i'm waiting for 30 weeks for some arbitrary reason, but i have happiest baby on the block and healthy sleep habits, happy child waiting for me on the bookshelf.

coming up in future posts . . .
✰ controversial baby-related topics: breast or bottle [or both]? epidural or all-natural? cloth diapers or disposable?

✰ december goal + resolutions for 2012

✰ the hypothalamic amenorrhea post [i haven't forgotten! but i've procrastinated due to feeling too much pressure to make it a scholarly article when really i just want to share what i've read and learned. i'm just going to charge ahead and put my thoughts out there. so it's coming!]

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11.30.11

workout: i had an early meeting, so rest day

espanol: no, lo siento.

reading: 20 minutes on transient hypoglycemic states in the newborn/infant

dinner = leftovers. and i didn't wait until bedtime to eat it. good thing, because josh never made it home!!! i'm glad we both have another weekend off together, even if it will involve a move down the hall.

pigeons + my evening routine

2011-11-30T06:18:00.010-05:00

PoDs
i absolutely loved gretchen rubin's blog post yesterday, in which she asks: what's your pigeon of discontentment?

at first, i was put off by the idea of a negative topic on her happiness blog -- but as long as the focus is on proactively seeking out and eradicating these [virtual!] pigeons, i think it's a great idea. her definition:

A Pigeon of Discontent isn't a major happiness challenge, but rather, an ordinary problem that has settled into roost.

commenters came in droves, and i found it interesting that many people [including myself!] suffer from a few very common PoDs.

a few examples from her comments
◼ being alone too much [not having enough friends or a significant other]
◼ habitual procrastination or being late
◼ clutter
◼ repeated self-sabotage of efforts to be healthy [skipping exercise, eating poorly]

me
◼ spending too much time in front of a screen [laptop or tv] because it's the default
◼ getting into a pattern of rushing [often for no real reason]
◼ having expectations about what 'should' happen at work, and getting heated when things don't go exactly as expected or planned
◼ lack of a viable evening routine

did someone say 'routine'?
i know. for someone who has put a lot of thought into how i spend the morning, my evening routine -- well, currently it's pretty terrible. here's a snapshot of last night, which seems to be the [unfortunate] pattern lately:

somewhere between 5:30 - 6:30: arrive home from work [i know -- i work really decent hours these days!]

6:15: flop down in front of computer, procrastinating because i know i have reading for work i should do. often i am super-hungry, so i scrounge up something small in the fridge. this is never satisfying because really i want dinner already. text josh, who says he will likely "leave at 8" [why yes, that's a 15 hour day. glad i'm not a vascular surgery fellow.]

6:40: actually start doing reading. find it's not so bad once i start . . .

7:05: ahh, that's enough after a long work day. make dinner.

7:35: dinner's ready! and i am ready to eat it. in fact, the baby is TELLING ME i need to eat it in the next 5 minutes or we will both surely perish. i text josh to see if he's on his way soon.

7:40: receive text that he has a couple more patients to see

7:50: receive message from brain that my blood sugar is reaching critical levels. distract myself with TV/computer/etc to keep from gnawing off my own hand.

8:05: give up and eat dinner by myself. realize that eating this close to bedtime while pregnant = foolproof heartburn recipe. yay!

8:45: josh arrives home. accompany him at the table for dinner for a very brief period while trying not to pass out asleep

9:30: BED.

there are certainly variations on this theme. but the overall gist is that there's a lot of waiting, a lot of wasteful killing time [mostly because i'm too uncomfortably hungry/tired to feel like doing anything else!], and not much else. please note that i am in no way blaming my extremely hard-working husband, and i understand that he needs to wrap up care for the patients on his team, as long as his day is. but i'd still like a better solution for the time being.

a delicate balance
i am lucky in that i think [hope] this situation is fairly temporary. josh will only arrive home so late when he is on service, which is 50% of the time [and only 1.5 years left!]. obviously, i'm going to be MUCH busier in a few short months, and i will probably be happy if the only thing i achieve in the evenings is getting baby SHU to eat and fall asleep without incident. but those facts don't mean that now doesn't matter, and really i'd like to enjoy now a little bit more.

so, what to do? not sure! i think that i may have to eat earlier and accept that it's okay. i can still hang out with josh when he gets home [and honestly the outcome is usually the same whether i attempted to wait or not!]. i also would like to find some relaxing evening activities that DON'T involve a screen of any sort. i don't knit, but i do read and like music and love to bake. a restorative yoga practice or relaxing podcast could be nice. and this time of year, i can work on getting some holiday tasks done [gift shopping, cards, etc] -- yes, a screen would be involved but these activities are still fun and more worthwhile just surfing mindlessly.

so: i guess i've found my december goal -- or perhaps it found me!

questions for you . . .
-- what are your PoDs? [personally i found it very helpful to take a moment to lay mine out]
-- any suggestions to help me take back my evenings?

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11.29.11

workout: 30 minutes elliptical while reading whole living mag

the dinner i was waiting for

i don't know if this just tasted extra-good due to my hunger, but i LOOOVED this moroccan-style beef with chickpeas [yes, the original recipe is lamb, but i had to substitute because whole foods was out!]

this recipe is essentially meat/beans/veg/spices, served with arugula-spiked couscous. it was warm, comforting, and tasted like it was loaded with nutrition. it's funny to think that a few months ago i was in the midst of crazy food cravings and aversions and now i'm almost the opposite -- i just want nourishing FOOD and a good amount of it. i am loving vegetables and also meat, whereas before i could sort of take it or leave it. i also feel like i'm continuing to grow every day [i'll try to do a picture for tomorrow]! hopefully my body knows what it's doing . . .

spanish: check

reading: 25 minutes on neonatal hypoglycemia

relieved to be awake

2011-11-29T06:11:00.009-05:00

message from somewhere
i had horrible apocalyptic dreams last night.

sometimes i wonder if dali had some secret device to capture images in his sleep
[image source]
this may be pregnancy-related: some fancy trick of hormones, or perhaps a subconscious way of dealing with the otherwise unfathomable life changes to come.

i have had a number of baby dreams in the past. usually, i find myself with a healthy full-term-sized infant that just happened to come out at 20-some weeks. [surprise?]. often, it's a boy instead of the girl i saw on 2 ultrasounds. these vignettes are a little weird, but not unhappy.

but my dream last night had no baby. instead, there was just a lot of death. apparently, something very bad happened [to the earth? some sort of apocalypse? not sure] and it was time for everyone's life to end, and i watched loved ones jump into an open chasm to drown while preparing for my own fatal leap. it felt incredibly real -- likely aided by the natural soundtrack of rain on our building roof -- and it was absolutely horrible.

i woke up and thought i was safe, but another tale of death greeted me in my google reader.

perhaps the universe is trying to remind me of something, as i am lulled into a content state of nesting and waiting. the hard-to-bear truth is that life is finite and i have no idea how much time i have left, or how much anyone has left. nothing [including the baby girl currently doing flips in my uterus] is certain. which also means . . .

plans are interesting to think about, but it's now that matters.

i spent some time this morning trying to shake out the scary images. i cracked open the new notebook, brainstorming [and trying to distract myself] with some little things that i would still love to address in my life -- but admittedly i now feel silly thinking about some of them.

but maybe these little things do matter. life is made up of little things, right? small moments and feelings and sometimes actions, all adding up to something much more. above all, i want to cultivate health, love, and happiness -- in myself, and in those around me. i want to create memories to cherish, but that's secondary. i really want to LIVE them while they are happening.

i have no idea what i am trying to say with all this [definitely NOT that improving my hydration will lead to immortality and eternal bliss]. i just feel like there is a lot to think about. thank you, rain and progesterone and perhaps a slightly warped subconscious. it's going to be an interesting tuesday.

roundup

2011-11-28T05:33:00.010-05:00

thanks
for your thoughts and lovely comments on yesterday's post. it was never meant to be a goodbye; just something that i've been thinking about lately and will likely continue to mull over. but know that your words warmed my heart regardless! for now, we will return to the regularly scheduled mind dump / life reflection space that this little blog has become for me over the years.

this weekend
contained ALL of the essential elements . . .

☑ sleep and LOTS of it.

☑ run in perfect weather with this american life, of course

☑ a little retail therapy

i finally found a coat that doesn't make me look ridiculous: voila!
it's not the world's warmest, but i live in NC, not wisconsin. and pregnancy = hormonal warmth + extra bonus padding to start with!

☑ much-needed pedicure

☑ lots of relaxing movie time josh and i spent many hours snuggling together + watching movies. and we ventured down the street [on foot -- it's super close!] to see this one at the local theater:

the way was about the journey rather than the destination . . . and was perfect for a saturday afternoon
at home, we saw everything must go [depressing but well-done] and finished watching fantastic mr. fox [wes anderson + roald dahl = awesome].

☑ fun meals out at rue cler and parker & otis

☑ cozy meals in

last night's kale + white bean soup, with recipe from eating well
reflective time
with a bit of extra white space, i was able to do some thinking about things, which spawned yesterday's post and also some more concrete thoughts about goals, resolutions, and the way i want to spend the next four months pre-baby -- and beyond.

i'll save these thoughts for a later post, but check out the pretty little receptacle for the newest batch of ideas, lists, charts, and the like for these months + the new year:

shown with my planner for size -- it's about 4" x 6"
dots = the new less-intrusive graph paper
available here, although i bought mine at parker & otis.

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week of 11.21 - 11.27

workouts:

a good amount of running + other cardio. ZERO yoga/strength. i will remedy this starting now!

spanish: 3 / 7. i took thanksgiving off!

reading: none, really -- abysmal. but i think i needed a break.

cooking: in x 4 [including thanksgiving!], out x 3 <-- i'd like to get this to a ratio of 5:2 or 6:1 in the future, so i'm tracking for now!

my daily discipline

2011-11-27T08:37:00.006-05:00

on days like this . . .
i wonder if i'm doing things right by blogging every day.

i know there are upsides to having an automatic daily practice. sometimes, things -- honest, real, important things -- come out that i had no idea i wanted to write about. and creating something, even if it's not anything earth-shattering, is a nice start to the morning.

other times -- and i am thankful that these times are relatively sparse -- i sit and try to type, but just don't get inspired. you all just get to view some mediocre photography [although the following shot is my favorite of 2011] or i post a meme or list of sorts, not having anything real or exciting to say.

happy thanksgiving, baby
this space can be sounding board for me; a mind-dump of sorts. sometimes i work through my own issues and things seem more clear. my favorite posts are those that are honest and raw, and judging from the responses, you all tend to agree. i guess i'm less excited about lifecasting than i was a year ago. yes, josh and i enjoyed some movies and a nice dinner out last night. but is it really something i need to document, or anything anyone else feels like reading about?

♥ i do love to document goals and aspirations -- this gives me an idea of what i'm really striving for, and i know i love to read these kinds of posts on other blogs.

♥ i like to blog about extraordinary experiences, although i suppose even simple things qualify.

♥ i enjoy writing about meal-planning, cooking, and sharing dinner photos.

♥ i like writing about lists and organization.

♥ i used to love writing about running/training/fitness goals, but baby SHU [and TTC] put quite a damper on that. [i miss REAL training plans!]

♥ sometimes i have fun doing restaurant reviews, but lately i've just felt like sitting back and NOT whipping out my camera between courses [besides, josh isn't a huge fan of this practice].

♥ i adore getting your feedback!

but is it all too much?
should i scale back? would i be happier posting a few times a week -- or just once in a while, or [the horror] not at all? will the blog become a burden after my due date, or an even more critical release valve? one of my favorite bloggers [heather of hangrypants] left the whole scene behind a few weeks ago and i would be lying if i didn't think about what it would be like to . . . well, not blog anymore after 7 [!!] long years.

anyway, i promise this post is not a goodbye, and you can expect a regular ol' entry tomorrow. but i just wanted to spill what was on my mind. as usual.

gift ideas 2011

2011-11-26T08:00:00.007-05:00

9 hours
for better or for worse, 9 hours of sleep seems to be the magic number for me these days. i feel ready to actually do things today, as opposed to yesterday. i was on call from home for most of the day, but ended up indulging in the laziest day i can recall in months -- seriously! no workouts, little movement of ANY sort, and just a lot of time planted on either the couch or the bed or a chair. there was even a long midday nap included. i think the most strenuous task i undertook was consuming the last slice of pecan pie [it was hard work, but someone had to do it].

and it felt great.

black friday?
one thing [among many] that i did not do yesterday was to go shopping. admittedly, it's easier to resist the sales when maternity clothes are one's only option for the time being -- just NOT as fun as anthro, no matter how you slice it. but frenzied gift-buying is also not my scene. i tend to do a lot of my gift-season shopping online, and over the years i've really tried to focus more on consumable and/or practical gifts [i wrote about this last year, too].

because the thing is: i'm not at all anti-gift. gifts are one of life's many pleasures -- both to give AND receive [right now i'm sitting on a birthday surprise for josh that makes me giddy whenever i think about it]. it's just that i'm anti-clutter, anti-waste, somewhat anti-big-box-retail, and anti-shopping-in-a-frenzied mob.

here are some things i'm considering as gifts this year . . .

✔ gourmet coffees or teas [or chocolate! or cheese! or wine!]

washi 2-tin gift set from teavana, $25
✔ luxury bath & body products

citron de vigne shower gel from fresh, $18.50
something like this WILL get used, and it will bring a little dash of happiness to the giftee every time she [he?] gets in the shower.

✔ hard-working academic on the list?

can't go wrong with useful + fabulous stationery supplies in my opinion! gel-pen set at jetpens, $32
✔ magazine subscription: a gift that keeps on giving, all year round!
great for a gym-goer who reads during workouts. yoga journal at amazon = currently just $5!
✔ a llama.

or a pig, goat, rabbits . . . these animals from heifer international help fight hunger and poverty worldwide

i included links, but it's even better if you can purchase gifts like the above from local merchants, something i would like to do more of [it's just so tempting to check off my shopping list with a few thoughtful clicks!].

what's on your gift list this year? or your own personal wish list? personally, i don't really feel like i need or want anything right now other than baby-related items [which i haven't really even started to think about in any practical sense].

thanksgiving 2011: picture book edition

2011-11-25T08:43:00.004-05:00

back with actual words tomorrow!

turkey trot

2011-11-24T07:32:00.001-05:00

PW

i'm pretty much guaranteed a personal worst today, and i couldn't be more thankful.

love and happy thanksgiving to all!

pumpin'

2011-11-23T06:48:00.007-05:00

not a misspelling
pumpkins are certainly ubiquitous these days, but that is not what i was referring to. as you all know, i work in pediatric endocrinology. this means i spent a lot of time taking care of kids with diabetes.

in a nutshell, diabetes is a pain-in-the-ass disease. yes, it's wonderful that there are ways to manage the disease [the discovery of insulin turned 90 this year!], but all of them require a significant investment of time and energy, and another thing to always worry about -- not exactly fun for an already busy 15 year old, or mother of a toddler.

we see our type 1 patients approximately every 4 months in clinic -- which is fun as a physician, because you get to know these kids well. each visit begins with a finger prick to check the hemoglobin A1c -- a measure of what average glucose levels have been over the past 3 months. it's like the diabetes report card, and it's a lot of pressure! keeping the A1c in the goal range is NOT an easy feat, and it can lead to a lot of power struggles/stress within families.

we often spend time during the visits trying to troubleshoot and coach the patients [or parents, depending on age] about how to make things better. but even without the experience of having diabetes, i can appreciate that many of the things we suggest ["keep carbs consistent!" "always bolus BEFORE you eat!" "NEVER miss an insulin bolus!" etc etc] are easy to SAY . . . but not in the least easy to DO.

and that's why i think it's awesome that i am currently wearing an insulin pump.

don't worry -- it's only saline in there!!
some reps from one of the pump companies provided loaners to all of the endocrine fellows [i'm the sole pediatric representative!]. yesterday afternoon, i got to experience what it feels like to have the little catheter inserted into my skin [we chose an area as far from the baby as possible :) ] and to have something attached to me all the time. so far? borderline annoying. it isn't painful [although i can 'feel' the insulin going in for boluses!], but it's hard to hide under clothes, since it's the size of a pager with tubing attached.

to make the experience more real, we were also given glucose monitors and instructed to basically use the pump as a patient with diabetes would. this means that i have a basal rate [low level of saline] going at all times, and that i have to give myself extra insulin [bolus] every time i eat anything with a significant number of carbohydrates.

this means checking sugars [again, not really painful but another extra thing to do!]

pre-breakfast. i'll spare you the action shot of the finger-prick!
[i am sure my blood sugars are higher now than usual -- pregnancy is a naturally insulin-resistant state due to a number of hormonal changes. hence the need for routine screening for gestational diabetes! i guess this will be a little preview for me.]

then, you have to estimate the number of carbohydrates in the meal you're about to eat. my standard breakfast had 56 grams -- woah! then, you enter that number along with your blood sugar, and the pump calculates how much insulin is needed.

you then press a button and it goes in.

again, nothing about the process is terribly tricky, but it is time-consuming and i can already see how patients are tempted to just skip it all sometimes, especially if they'd have to leave the room in order to not have to do it in front of friends. and i realize this is 50 times easier for me than it is for someone with diabetes -- i don't have to recheck sugars if they get out of control during the day, because they won't! and there's no need for me to worry that the catheter could kink during the night, causing me to be super-sick by morning [there are alarms for these things, but they aren't always fail-proof -- we get a fair amount of PICU admissions just due to pump failure].

but i've had this on for less than a day [we're supposed to wear it for 3!] and i already feel like i get it a little more. which is better than nothing! wonder what my glucose will be after pumpkin pie . . .

--------------------------------------------------------------------------------------------------

11.22.11

workout: 3.1 mi, 10:05/mi average.

chicken caesar for some reason, caesar salad has been one of my favorite foods during pregnancy. i decided to make the cooking light version this week.

the verdict? ehh, okay. but it was missing something -- probably the creaminess that makes it unsuitable for cooking light in the first place! i didn't calculate carbs last night for the pump [figured i'd start today] but they probably would have been pretty low.

spanish: check . . . i think. i almost can't remember?!

reading: NO again!! in my defense, i am participating in a prenatal/children's health study and i had a post-work visit that ended up taking almost 2 hours.

7 things

2011-11-22T06:36:00.008-05:00

1. !!!!!

smallest possible toms. if only they carried newborn size . . .
2. how is it thanksgiving in 2 days!? because we're not traveling like we usually do, i keep forgetting about it altogether. i put myself in charge of dessert and now i'm getting nervous. i'm thinking pumpkin cheesecake [with gingerbread crust] and classic pecan pie.

pretty sure mine will not look as good as martha's
3. um, we're moving in less than 2 weeks. yes, it's just down the hall, but still! ARGHGH!

4. wherever you go, there you are is inspiring, although i can't seem to read more than 3 pages without falling asleep [i blame me, not the book]. i've heard many of the ideas before ['wash the dishes to wash the dishes', for example], but some things are worth hearing more than once.

yes, just like that
5. OB appointment was fine. BP great. heartbeat loud & clear. weigh-in was once again a little traumatic, if i'm being honest -- i'm now more than 10 lbs over the heaviest weight i have ever seen in my non-pregnant life. i was up 4.6 lbs from my last appointment 4 weeks ago, which is a little over the '1 lb a week' adage. so maybe i will give the pumpkin ice cream a rest. [but NOT the thanksgiving-day desserts. i would eat them even if i had to accompany them with a nice shot of insulin].

6. i'm feeling overwhelmed somehow already [i think i just need to sleep more.] i love this simple list of 55 ways to take care of yourself when you are really busy [from the freedom experiment via repsych. my favorite?

Brighten your day with colourful pencils and pretty stationary. It doesn’t have to cost much, but it will make a huge impact on your happiness – especially if you’re a stationary and design geek… (well, who isn’t?)

7. seriously, i can't stop looking at these.

and i can't help smiling every time i do.

off to get in my last 'training' run before the thanksgiving 5k!!

---------------------------------------------------------------------------------------

11.21.11

workout: 30 minutes elliptical, levels 8 - 10.

dinner: out with my lovely coworkers . . . to the cheesecake factory! i hadn't been there in years and wasn't sure what to expect, but my salad [with oranges, goat cheese, pecans, cranberries, avocado] was really good. as was the cheesecake we all shared.

spanish: check

reading: oops. i need to get my mojo back on this one. i guess maybe 21 days doesn't really make it guaranteed automatic . . .

dove spa-finder gift card giveaway!

2011-11-21T12:00:00.000-05:00

nourishment and self-care
21 weeks into my pregnancy adventure, the terms above have taken on a new importance.

things are different now. feeling good requires a bit more effort on my part: more rest, more sleep, and more attention to things like nutrition and body care. self-care comes in many different forms; here are just a few things i try to incorporate that come to mind . . .

cooking with fresh, local produce
hitting the mat
date nights!
couch time [although this shot was at IKEA!]
occasional beach getaways
getting into nature

review: dove nutrium moisture body wash
showering/bathing rituals are one important component of self-care. i like to leave the shower feeling cleaner [duh] and more relaxed [ahhh] than when i get into it. so, i was excited when i received an offer to review this product:

dove nutrium moisture body wash
first of all, i trust dove. it was all my parents used on my sister + me as kids; i still love the smell of their classic bath bar for that reason. second, i am definitely a body wash fanatic. i've tried multiple brands and tend to bounce around a lot when some new smell catches my fancy at the drugstore or whole foods.

i started using this body wash a few days ago, parking it next to the [overpriced but heavenly-scented] body wash currently in rotation. the verdict? LOVE IT. it has an extremely light texture but goes on feeling silky-smooth. it is great for shaving [multitasker!] and leaves my skin feeling hydrated and soft. i wish it smelled more like the classic bath bar, but i still don't mind the smell [and that's coming from someone with SUPER-SCENTING abilities right now -- trust me, it's a double-edged sword].

giveaway!!
okay, here's the really exciting part! one of my absolute favorite ways to nourish myself is with a well-earned massage. nothing feels more decadent, right? by leaving a comment on how you nourish yourself on this post, you will be entered to win a $100 SpaFinder gift card!!! ie, massage without any of the $$$-guilt.

Dove's official site: Dove

Contest rules: this contest will run 11/21 - 12/21. Visit the Official Rules

BlogHer round-up, with more chances to win: Visit the Prizes and Promotions section

the fine print
No duplicate comments.

You may receive (2) total entries by selecting from the following entry
methods:

a) Leave a comment in response to the sweepstakes prompt on this post

b) Tweet about this promotion and leave the URL to that tweet in a comment
on this post

c) Blog about this promotion and leave the URL to that post in a comment on
this post

d) For those with no Twitter or blog, read the official rules to learn about
an alternate form of entry.

This giveaway is open to US Residents age 18 or older

Winners will be selected via random draw, and will be notified by e-mail.

You have 72 hours to get back to me, otherwise a new winner will be
selected.

The Official Rules are available here.

good luck to all of you!

please note: this is a compensated review post.

weekend eating

2011-11-21T06:05:00.004-05:00

what i ate sunday
i have to admit i definitely eat healthier on weekdays -- monday through thursday, really. i think many americans do -- to the point where it's almost part of the culture! the work week ends, and suddenly my fingers are itching to dial for takeout pizza. sunday = brunchy meals and/or a trip to LoYo. and ~ 21 weeks ago, there was also usually some wine or beer involved. [and yeah - i miss it!].

health and fitness magazines would probably say that this kind of weekend eating is 'wrong', but if so, i don't really want to be right. it's enjoyable, usually kept within reasonable limits, and i'm usually ready to get back to cooking by sunday night.

yesterday, i decided to document a day of typical weekend fare. here you go! a second-trimester sunday, in food form . . .

7 am: breakfast. the usual one.

sorry. i'm very boring in this realm. even on weekends!
[note: the espresso is decaf]

10 am: hydration + vitamin

2 chewables + water with a splash of OJ
12 pm: out to brunch with josh @ guglhupf

no makeup, sorry! but happy w/ decaf #2 + the tiny sugar cookie that came with it
omelette with mushroom, leeks, + grueyere, plus fruit
i didn't eat the french bread -- instead, i swapped it out for a piece of whole wheat raisin on this plate, and a slice of josh's cheese:

cheese is still a favorite these days
3:30 pm: pre-yoga snack

slice of saturday's baking project
[plus more water].

8:00 pm: dinner

butternut + spinach lasagna with a simple arugula salad
note: the lasagna is tasty, but took >2 hours from start to finish. only acceptable for a sunday night.

9:00 pm: dessert

whole foods brand pumpkin ice cream
i'm pretty sure i didn't need this [and i'm hoping i won't get my wrists slapped after my weigh-in at my OB appointment today!], but it was a lovely sweet ending.

do you tend towards more indulgent meals on the weekend, or is it pretty much the same as the rest of the week?

------------------------------------------------------------------------------------

11.20.11

workouts: weekly rundown

cooking: the aforementioned labor-intensive lasagna.

spanish: i take weekends off! but diving in now . . .

weekend scene

2011-11-20T07:57:00.002-05:00

down time
this weekend hasn't been 'exciting', but the leisurely down time is exactly what i needed. yesterday included . . .

✔ 'long' run [4 mi], 9:55/mi average. my running jacket is thisclose to not zipping over the bump.

✔ massage: amazing. my feet [plantar fascia?] were feeling sore after the run, so i had extra attention there. personally, i find massages to be the perfect post-call treat: completely indulgent but truly relaxing and also legitimate self-care. in my fantasy world, i will still be able to occasionally go post-baby and actually get to lie face-down again.

✔ chick flick on demand:

i still have the last 35 minutes left [because i am incapable of staying up past 9 pm these days], but i liked the first 2/3.

✔ baking project
there were 3 quickly-ripening bananas on the kitchen counter. i had nowhere to go and nothing to do.

i wonder if josh planted them there knowing what would happen. i used CL's classic banana bread recipe, but i subbed 1/2 whole wheat pastry flour and added some chocolate chips that seemed to be shouting "USE MEEEEEE" from the freezer door.

with milk. so i can pretend my snack is sort of healthy even if it's full of chocolate
the only thing that would have made yesterday more lovely would have been if josh was home with me. we have to get our call weekends back in sync . . .

today

this list looks longer than it really is, i think. i anticipate another relaxing day. off to finish last night's movie!

a study in contrasts

2011-11-19T07:50:00.005-05:00

weekend face-off

the question is: would i appreciate this one so much if the last hadn't happened?

hmmm.

goals for today
♥ run
♥ few errands
♥ read [just got the new murakami and i'm excited about it despite this review!]

♥ not think about work

back with a report tomorrow! if you do have to work this weekend, just think about how much sweeter that next day off will be. it's easier said than done, but i have to believe there's something to the idea that negative experiences bring the rest of life into a more colorful and beautiful relief.

off to enjoy the day!

small victories

2011-11-18T06:29:00.005-05:00

this AM
after a week of lackluster motivation and flagging energy, i just speed-cleaned the apartment this morning. i'm sure it wouldn't pass the white-glove test, but it passes the 'generally in order and not disgusting' test.

our apartment has an open floor plan and rather minimal decor [read: we like things relatively spare, and we also didn't put much time into decorating]. as a result, when it gets messy, it goes from peaceful urban haven to disaster zone in an instant.

but for now we're back to serenity . . .

i love our IKEA couch!
good morning, durham
kitchen worthy of cooking in
a made bed makes all the difference . . . and yes, another IKEA classic.
and now i feel like i can start the day on a high note. i may also be a little giddy about the fact that i get to sign the endo pager over in just 1.25 hours [i have clinic in raleigh]!

HAPPY FRIDAY TO ALL!!

tech babies + virtual pages

2011-11-17T06:14:00.009-05:00

modern dilemmas
the other day, i was browsing amazon and laid eyes on their new e-reader/tablet, the color kindle fire. a poor [fine, less rich]-man's iPad at $199, the ads are touting its abilities as a convenient, portable media-player/reader. you can very quickly buy books/media/etc from the amazon store, keep them up in a 'cloud' somewhere, and access them whenever you need to.

to be honest, it looks like a pretty cool device to me, especially for travel. but then i saw this:

WHAT?! they want me to curl up with my baby girl and have her stare into a screen while we turn fake pages? i just can't. i know i'm still a bit of a luddite these days, even if i did finally succumb to the iPhone [and i have to admit - i have ended up liking it a lot. though i still only have a grand total of like 4 apps]. i love my paper planner and have no intention of converting it to digital. i print out articles at work when i really want to read them closely. and i want to cuddle up at bedtime with our baby and a BOOK, a real-life book that she can play with and touch and drool on.

i don't want her to be an iPad whiz before she can walk.

although i admit this one is still cute
on the flip side, i don't want to become one of those militant anti-tech parents who will freak out if their kid sees 5 minutes of TV before the age of 2 [even the american academy of pediatrics advises against it] . . . but i may lean a little bit in that direction. i want my child to learn to appreciate and notice her real surroundings, not just what is on a little screen in front of her. i want her to run and play outside, not just jump around indoors with 2020's answer to the wii fit.

and i want her to have at least a chance to experience what 'real books' are like -- who knows, they may be gone from many schools by the time she takes her seat in kindergarten.

what are your thoughts on babies/kids and technology these days? am i being unrealistic or silly for my loyalties to paper over silicon? do you use an e-reader?
food for thought on a thursday!

ps: ONE more night on the pager. woohoo!

------------------------------------------------------------------------------------

11.16.11

workout: rest day [i had an early meeting to go to]

leftovers = chili replay. worked for me. and even more exciting was dessert:

obtained on an emergency stop on the way home from work. it was necessary.
espanol: no!! ahh, i broke my streak, despite having plenty of time to watch my DVR'd glee last night. [i blame call and call-related grumpiness]. but about to start on today's right now.